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Characteristics and association with survival of respiratory-related hospitalization in Japanese idiopathic pulmonary fibrosis patients
Institution:1. Unità Operativa di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe MultiMedica, IRCCS, Milan, Italy;2. Department of Clinical and Biological Sciences, Center for Rare Pulmonary Disease, San Luigi Gonzaga Medical School, Turin, Italy;3. Regional Centre for Rare Lung Disease, University of Catania, Catania, Italy;4. Pulmonary Unit, GB Morgagni Hospital, Forlì, Italy;5. Clinica Pneumologica, Department of Health Science, University of Milan Bicocca, AO San Gerardo, Monza, Italy;6. Unit of Respiratory Disease, University Hospital, Modena, Italy;7. Respiratory Diseases Unit, Department of Medicine, “Tor Vergata” University Hospital, Roma, Italy;8. Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy;9. Respiratory Diseases and Lung Transplant Unit, Department of Internal and Specialistic Medicine, AOUS, Siena, Italy;10. Department of Respiratory Diseases, S. Camillo-Forlanini Hospital, Roma, Italy;11. Division of Pneumology, Department of Respiratory Diseases, High Speciality Hospital “V. Monaldi” Naples and University of Naples Federico II, Naples, Italy;12. Department of Pneumology, University Hospital of Trieste, Trieste, Italy;13. Department of Molecular and Translational Medicine, University of Brescia, Italy;14. IRCCS MultiMedica, Milano, Italy;1. Assistance Publique-Hôpitaux de Paris, Service de Pneumologie A, Hôpital Bichat, DHU FIRE, Paris, France;2. INSERM, Unité 1152, Paris, France;3. Université Paris Diderot, Paris, France;4. Medical University of South Carolina, Charleston, SC, USA;5. Minnesota Lung Center, Minneapolis, MN, USA;6. Ruhrlandklinik, University Hospital, University of Duisburg-Essen, Essen, Germany;7. Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, and Department of Medicine, Monash University, Melbourne, VIC, Australia;8. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan;9. Department of Pulmonary and Critical Care Medicine, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, South Korea;10. Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany;11. Center for Interstitial and Rare Lung Diseases, Pneumology, Thoraxklinik, University of Heidelberg, Heidelberg, Germany;12. German Center for Lung Research, Germany;1. Third Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, Zabrze, Poland;2. Department of Nutrition-related Disease Prevention, School of Public Health, Medical University of Silesia, Bytom, Poland;3. Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Poland, Medical University of Silesia in Katowice, Katowice, Poland;4. Department of Social Medicine and Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Katowice, Poland;1. Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel;2. Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal;3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160, Nishioiwake-cho, Seto, Aichi 489-8642, Japan;2. Department of Respiratory Medicine, Tohoku Pharmaceutical University, 1-12-1, Fukumuro, Miyagino-ku, Sendai 983-8512, Japan;3. Department of Internal Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyou-ku, Tokyo 113-8603, Japan;4. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1, Tomiokahigashi, Kanazawa-ku, Yokohama 236-0051, Japan;5. Department of Respiratory Medicine, Tenri Hospital, 200, Mishima-cho, Tenri 632-8552, Japan;6. Center for Preventive Medicine, Saiseikai Kumamoto Hospital, 5-3-1, Tikami, Minami-ku, Kumamoto 861-4193, Japan;7. Third Department of Internal Medicine, Sapporo Medical University Hospital, 16-291, Minami-ichijo-nishi, Tyuou-ku, Sapporo 060-8543, Japan;8. Department of Respiratory Medicine, Nakata Clinic, 2-2-1, Naikoucho, Chiyodaku, Tokyo 100-0011, Japan;9. Department of Medicine, Division of Pulmonary Medicine, Jichi Medical University, 3311-1, Yakushiji, Simono, Tochigi 329-0498, Japan;10. Department of Respiratory Medicine, Fukujuji Hospital, 3-1-24, Matsuyama, Kiyose, Tokyo 204-8522, Japan;11. Department of Respiratory Medicine, South Miyagi Medical Center, 38-1, Ohkawara-cho-aza-nishi, Shibata-gun, Miyagi 989-1253, Japan
Abstract:BackgroundThe characteristics and significance of respiratory-related hospitalization in patients with idiopathic pulmonary fibrosis (IPF) in Asian countries remain unknown. The purpose of this study was to define the characteristics of respiratory-related hospitalization and to inspect the relationship between respiratory-related hospitalization and subsequent survival in patients with IPF in Japanese general practice.MethodsPatients with IPF who underwent clinical evaluation between February 2008 and August 2017 were screened. Only those who had undergone evaluation within 1 year after the diagnosis of IPF were included in the study. The post-diagnosis pulmonary function tests were considered the registration point. We then performed a 6-month landmark analysis including only patients who were alive 6 months after the registration. The characteristics of respiratory-related hospitalizations during the 6 months after registration and the association between respiratory-related hospitalization and survival were investigated.ResultsA total of 106 patients with IPF were included in the study. The mean forced vital capacity (FVC) at registration was 80.2 ± 25.1% predicted. Seventeen patients (16.0%) had respiratory-related hospitalization during the 6 months after registration. Pneumonia was the most frequent reason for hospitalization (47.0%), followed by acute exacerbation of IPF (29.4%). In multivariate analysis, % predicted FVC (hazard ratio: 0.98, 95% confidence interval: 0.96–0.99, p = 0.004), 6-month decrease in % predicted FVC (1.05, 1.02–1.08, 0.005), and respiratory-related hospitalization (2.45, 1.24–4.85, 0.009) were significantly associated with survival.ConclusionsPneumonia is the most frequent cause of respiratory-related hospitalization in Japanese IPF patients. Furthermore, respiratory-related hospitalization is significantly associated with subsequent poor survival.
Keywords:Hospitalization  Idiopathic pulmonary fibrosis  Interstitial lung disease  Pneumonia  Respiratory infections  BMI"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"body mass index  CI"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"confidence interval  COPD"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"chronic obstructive pulmonary disease  diffusing capacity of lungs for carbon monoxide  FVC"}  {"#name":"keyword"  "$":{"id":"kwrd0080"}  "$$":[{"#name":"text"  "_":"forced vital capacity  HRCT"}  {"#name":"keyword"  "$":{"id":"kwrd0090"}  "$$":[{"#name":"text"  "_":"high-resolution computed tomography  IPF"}  {"#name":"keyword"  "$":{"id":"kwrd0100"}  "$$":[{"#name":"text"  "_":"idiopathic pulmonary fibrosis  SD"}  {"#name":"keyword"  "$":{"id":"kwrd0110"}  "$$":[{"#name":"text"  "_":"standard deviation
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