Corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department
Abstract Interstitial lung disease (ILD), particularly idiopathic pulmonary fibrosis (IPF), has a poor prognosis. Corticosteroids are widely used in the treatment of acute exacerbation of ILD (AE-ILD). This study aimed to clarify the causes of AE-ILD, determine the efficacy of corticosteroids for tr...
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Nature Portfolio
2021
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oai:doaj.org-article:5598ecce509f4b1dbc8d4cf2f9ffc59c2021-12-02T13:19:22ZCorticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department10.1038/s41598-021-85539-12045-2322https://doaj.org/article/5598ecce509f4b1dbc8d4cf2f9ffc59c2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85539-1https://doaj.org/toc/2045-2322Abstract Interstitial lung disease (ILD), particularly idiopathic pulmonary fibrosis (IPF), has a poor prognosis. Corticosteroids are widely used in the treatment of acute exacerbation of ILD (AE-ILD). This study aimed to clarify the causes of AE-ILD, determine the efficacy of corticosteroids for treating AE-ILD, and detect differences in the mortality rate among subgroups of ILD. This was an observational retrospective single-center study. Patients with ILD who presented to the emergency department with acute respiratory symptoms from January 1, 2016, to December 31, 2018, were included. Patients with AE-ILD were classified into two groups depending on the prednisolone dose: low dose (0 to 1.0 mg/kg) or high dose (> 1.0 mg/kg). Mortality rates between patients with and without IPF were compared. This study included 182 patients with AE-ILD, including IPF (n = 117) and non-IPF (n = 65). Multivariate Cox regression analysis showed that corticosteroid dose (HR: 0.221, CI: 0.102–0.408, P < 0.001), initial P/F ratio (HR:0.995, CI:0.992–0.999, P = 0.006), and mechanical ventilation within 3 days of hospitalization (HR:4.205, CI:2.059–8.589, P < 0.001) were independent risk factors for mortality in patients with AE-ILD. This study showed that outcomes improve with higher doses of corticosteroids (> 1 mg/kg prednisolone) in patients with AE-non-IPF-ILD. However, this was not the case in patients with AE-IPF.Hye Jin JangSeung Hyun YongAh Young LeemSu Hwan LeeSong Yee KimSang Hoon LeeEun Young KimKyung Soo ChungJi Ye JungYoung Ae KangYoung Sam KimJoon ChangMoo Suk ParkNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021) |
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Medicine R Science Q Hye Jin Jang Seung Hyun Yong Ah Young Leem Su Hwan Lee Song Yee Kim Sang Hoon Lee Eun Young Kim Kyung Soo Chung Ji Ye Jung Young Ae Kang Young Sam Kim Joon Chang Moo Suk Park Corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department |
| description |
Abstract Interstitial lung disease (ILD), particularly idiopathic pulmonary fibrosis (IPF), has a poor prognosis. Corticosteroids are widely used in the treatment of acute exacerbation of ILD (AE-ILD). This study aimed to clarify the causes of AE-ILD, determine the efficacy of corticosteroids for treating AE-ILD, and detect differences in the mortality rate among subgroups of ILD. This was an observational retrospective single-center study. Patients with ILD who presented to the emergency department with acute respiratory symptoms from January 1, 2016, to December 31, 2018, were included. Patients with AE-ILD were classified into two groups depending on the prednisolone dose: low dose (0 to 1.0 mg/kg) or high dose (> 1.0 mg/kg). Mortality rates between patients with and without IPF were compared. This study included 182 patients with AE-ILD, including IPF (n = 117) and non-IPF (n = 65). Multivariate Cox regression analysis showed that corticosteroid dose (HR: 0.221, CI: 0.102–0.408, P < 0.001), initial P/F ratio (HR:0.995, CI:0.992–0.999, P = 0.006), and mechanical ventilation within 3 days of hospitalization (HR:4.205, CI:2.059–8.589, P < 0.001) were independent risk factors for mortality in patients with AE-ILD. This study showed that outcomes improve with higher doses of corticosteroids (> 1 mg/kg prednisolone) in patients with AE-non-IPF-ILD. However, this was not the case in patients with AE-IPF. |
| format |
article |
| author |
Hye Jin Jang Seung Hyun Yong Ah Young Leem Su Hwan Lee Song Yee Kim Sang Hoon Lee Eun Young Kim Kyung Soo Chung Ji Ye Jung Young Ae Kang Young Sam Kim Joon Chang Moo Suk Park |
| author_facet |
Hye Jin Jang Seung Hyun Yong Ah Young Leem Su Hwan Lee Song Yee Kim Sang Hoon Lee Eun Young Kim Kyung Soo Chung Ji Ye Jung Young Ae Kang Young Sam Kim Joon Chang Moo Suk Park |
| author_sort |
Hye Jin Jang |
| title |
Corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department |
| title_short |
Corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department |
| title_full |
Corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department |
| title_fullStr |
Corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department |
| title_full_unstemmed |
Corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department |
| title_sort |
corticosteroid responsiveness in patients with acute exacerbation of interstitial lung disease admitted to the emergency department |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/5598ecce509f4b1dbc8d4cf2f9ffc59c |
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