Abstract
Introduction: In the context of IPF, respiratory related admissions to hospital are associated with a high morbidity and short-term mortality with significant burden on secondary care services. It has yet to be determined how to accurately identify patients at risk of acute respiratory deterioration (ARD) or the prognosticating factors.
Objective: We sought to define the characteristics of hospitalised ARD-IPF patients in a realworld cohort and investigate factors associated with worse outcomes. Specifically, we wished to determine the association between baseline CURB-65 and NEWS2 baseline illness severity scores and mortality in IPF, given illness severity scores have not previously been validated in this cohort.
Methods: Single-centre retrospective observational cohort study.
Results: Of 172 first hospitalisations for ARD, 27 admissions (15.7%) were due to an acute exacerbation of IPF (AE-IPF), 28 (16.3%) secondary to cardiac failure/fluid overload and 17 due to pneumonia (9.9%). Other admissions related to lower respiratory tract infection, extraparenchymal causes and those without a specific trigger. Baseline patient characteristics were comparable for all underlying aetiologies of ARD-IPF. Treatment pathways did not differ significantly between AE-IPF and other causes of ARD-IPF. Short term mortality was high, with approximately 22% patients dying within 30 days. Illness severity scores (NEWS-2 and CURB65) were independent predictors of mortality in multivariable logistic regression modelling.
Conclusions: Our findings suggest significant mortality related to hospitalisation with ARD-IPF of any underlying cause. Our data supports the use of CURB-65 and NEWS-2 scores as Baseline illness severity scores that canmay provide a simple tool to help future prognostication in IPF. Research should be aimed at refining the management of these episodes, to try to reduce mortality, where possible, or to facilitate palliative care for those with adverse prognostic characteristics.
Objective: We sought to define the characteristics of hospitalised ARD-IPF patients in a realworld cohort and investigate factors associated with worse outcomes. Specifically, we wished to determine the association between baseline CURB-65 and NEWS2 baseline illness severity scores and mortality in IPF, given illness severity scores have not previously been validated in this cohort.
Methods: Single-centre retrospective observational cohort study.
Results: Of 172 first hospitalisations for ARD, 27 admissions (15.7%) were due to an acute exacerbation of IPF (AE-IPF), 28 (16.3%) secondary to cardiac failure/fluid overload and 17 due to pneumonia (9.9%). Other admissions related to lower respiratory tract infection, extraparenchymal causes and those without a specific trigger. Baseline patient characteristics were comparable for all underlying aetiologies of ARD-IPF. Treatment pathways did not differ significantly between AE-IPF and other causes of ARD-IPF. Short term mortality was high, with approximately 22% patients dying within 30 days. Illness severity scores (NEWS-2 and CURB65) were independent predictors of mortality in multivariable logistic regression modelling.
Conclusions: Our findings suggest significant mortality related to hospitalisation with ARD-IPF of any underlying cause. Our data supports the use of CURB-65 and NEWS-2 scores as Baseline illness severity scores that canmay provide a simple tool to help future prognostication in IPF. Research should be aimed at refining the management of these episodes, to try to reduce mortality, where possible, or to facilitate palliative care for those with adverse prognostic characteristics.
| Original language | English |
|---|---|
| Article number | hcaa214 |
| Number of pages | 9 |
| Journal | QJM |
| Early online date | 1 Jul 2020 |
| DOIs | |
| Publication status | Published - 1 Jul 2020 |
Research Groups and Themes
- Academic Respiratory Unit