Pronóstico de las exacerbaciones agudas idiopáticas en enfermedades pulmonares intersticiales difusas; seguimiento a un año

Abstract

Introduction: Acute exacerbations of interstitial lung diseases (AE-ILD) have been described for a long time. It was not until 2007 that the first definition was established, focusing exclusively on idiopathic pulmonary fibrosis (IPF) by classifying it as either triggered or idiopathic AE. Numerous studies have extrapolated this definition to evaluate the prognosis of other types of ILD. Objective: The objective of the present study was to assess the one-year prognosis of idiopathic AE-ILD and to identify potential mortality predictors. Patients and Methods: This is a retrospective, observational study. Patients diagnosed with AE-ILD upon hospital admission between May 2021 and September 2022 were identified from the Chilean National Thoracic Institute registry. AE-ILD was diagnosed according to the criteria proposed in the 2016 International Working Group report on AE of IPF. Triggered AE were identified and excluded from the analysis, leaving only AEs that were categorized as idiopathic. All-cause mortality at one year after exacerbation diagnosis and mortality predictors during this pe­riod were analyzed. Results: 32 patients with idiopathic AE-ILD were hospitalized. Nineteen patients (59%) were men, with an average age of 61 years. The primary etiologies of ILD were hypersensitivity pneumonitis and idiopathic pulmonary fibrosis. The in-hospital mortality rate was 40.6% (13 patients), and mortality in one year was 78.1% (25 patients). The median survival in IPF was 34 days and in non-IPF ILD was 51 days, and survival in one year was 10% and 27.3%, respectively. Upon analysis of the predictors of one-year mortality from AE diagnosis, no differences were identified between the variables. Conclusions: We report a high mortality rate in idiopathic AE-ILD (both IPF and non-IPF) without identifying the potential factors that determine changes in mortality.