Connective tissue disease-associated interstitial lung disease and outcomes after hospitalization: A cohort study

Ratwani, Ankush; Ahmad, Kareem; Barnett, Scott D.; Nathan, Steven D.; Brown, Anne

doi:10.1016/j.rmed.2019.05.020

Cited by 14 publications

(18 citation statements)

References 18 publications

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“…However, at the time of hospitalization, the differences in VC and DLCO between IPF and non-IPF patients had disappeared. As can be seen in E- Table 2, in comparison with most other studies, here the median time from diagnosis to hospitalization seemed to be longer [5,6,9] and patients were older [5][6][7]9], even though the baseline pulmonary function test (PFT) values in our study and those of others were approximately at the same level. A Japanese study has reported the PFT results of the investigated subjects near the rst hospitalization date were higher than in our material, even though the patients in that study and our own were approximately the same age [11].…”

Section: Discussionsupporting

confidence: 52%

“…Most of the register-based studies have investigated solely patients with IPF, while those of other ILDs are sparse. Table 1 presents data from previously published epidemiological studies and real-world data (RWD) studies on hospitalizations of ILD patients [5][6][7][8][9][10][11]. Table 1 here Acute exacerbation (AE) is a severe complication of ILD, which seems to cause signi cant mortality in all types of ILDs [12,13].…”

Section: Introductionmentioning

confidence: 99%

“…In other studies with access to the patient data, the proportion of AE-ILDs out of all the hospitalizations caused by an acute respiratory deterioration has ranged between 29-55% [5,6,10,11], when only two of these investigations included patients with non-IPF ILDs [5,11]. In the previous studies, which have not presented the exact data on the number of AE-ILDs, it was claimed that respiratory or cardiopulmonary hospitalizations increased the mortality of ILD patients more than hospitalization due other illnesses [7,9].…”

Section: Introductionmentioning

confidence: 99%

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Causes of acute respiratory hospitalizations predict survival in fibrosing interstitial lung diseases

Salonen

Vähänikkilä

Purokivi

et al. 2020

Preprint

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Background Acute exacerbation of ILD (AE-ILD) is a common reason for hospitalization; it is also associated with significant mortality. Less is known about the prognostic significance of other events causing acute, non-elective hospitalizations in ILD patients. Methods ILD patients hospitalized due to acute respiratory worsening were collected from medical records. Reasons for respiratory deterioration were classified into AE-ILDs and other causes. Clinical features and survival data of idiopathic pulmonary fibrosis (IPF) and other types of ILDs were evaluated and compared. Results In all, 237 patients (138 with IPF and 99 with other ILD) fulfilled the inclusion criteria. Of the non-IPF ILD types, the most prevalent subgroups were connective tissue disease-associated ILD (n = 33) and asbestosis (n = 22). The most common cause for hospitalization was AE-ILD explaining 41% of hospitalizations. Lower respiratory tract infection (22%), subacute progression of ILD (12%) and cardiovascular causes (7.2%) were other common reasons for hospital treatment. Patients with a lower respiratory tract infection had a more favorable prognosis compared with patients with AE-ILD. AE-ILDs were less fatal than cardiovascular or concurrent non-ILD-related causes for hospitalizations in non-IPF patients. High Gender-Age-Physiology (GAP) index was a marker for shortened survival and earlier AE-ILDs in all patients. IPF patients had a significantly shorter overall and post-hospitalization survival time compared with other ILDs. Conclusions Most respiratory hospitalizations in ILD patients were related to causes other than AE-ILD, which highlights the importance of accurate differential diagnosis in order to target the appropriate treatment for each ILD patient.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Causes of acute respiratory hospitalizations predict survival in fibrosing interstitial lung diseases

Salonen

Vähänikkilä

Purokivi

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Causes of acute respiratory hospitalizations predict survival in fibrosing interstitial lung diseases

Salonen¹,

Vähänikkilä²,

Purokivi³

et al. 2020

PLoS ONE

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Acute exacerbation of ILD (AE-ILD) is a common reason for hospitalization; it is also associated with significant mortality. Less is known about the prognostic significance of other events causing acute, non-elective hospitalizations in ILD patients. ILD patients hospitalized due to acute respiratory worsening were collected from medical records. Reasons for respiratory deterioration were classified into AE-ILDs and other causes. Clinical features and survival data of idiopathic pulmonary fibrosis (IPF) and other types of ILDs were evaluated and compared. In all, 237 patients (138 with IPF and 99 with other ILD) fulfilled the inclusion criteria. Of the non-IPF ILD types, the most prevalent subgroups were connective tissue disease-associated ILD (n = 33) and asbestosis (n = 22). The most common cause for hospitalization was AE-ILD explaining 41% of hospitalizations. Lower respiratory tract infection (22%), subacute progression of ILD (12%) and cardiovascular causes (7.2%) were other common reasons for hospital treatment. Patients with a lower respiratory tract infection had a more favorable prognosis compared with patients with AE-ILD. AE-ILDs were less fatal than cardiovascular or concurrent non-ILD-related causes for hospitalizations in non-IPF patients. High Gender-Age-Physiology (GAP) index was a marker for shortened survival and earlier AE-ILDs in all patients. IPF patients had a significantly shorter overall and post-hospitalization survival time compared with other ILDs. Most respiratory hospitalizations in ILD patients were related to causes other than AE-ILD, which highlights the importance of accurate differential diagnosis in order to target the appropriate treatment for each ILD patient.

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Lung Transplantation: A Viable Option for Connective Tissue Disease?

Zhang

Liu

Zhang

et al. 2023

Arthritis Care & Research

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Interstitial lung disease (ILD) and pulmonary hypertension (PH) caused by connective tissue disease (CTD) are one of the main causes of morbidity and death in patients. Although the International Society for Heart & Lung Transplant suggested that ILD and PH related to CTD are rare indications for lung transplantation in 2006, many lung transplantation centers are concerned that the multisystem involvement of CTD will affect survival outcomes after lung transplantation, and CTD is regarded as a relative contraindication for lung transplantation. However, long‐term and short‐term survival after lung transplantation in CTD patients is similar compared with survival in common indications for lung transplantation such as idiopathic pulmonary fibrosis (IPF), and no higher incidence of complications after transplantation in many lung transplant centers. This suggests that lung transplantation may be beneficial in CTD patients with disease that progresses to end‐stage lung disease, and CTD should not be considered a contraindication for lung transplantation. In the future, more prospective studies are needed to analyze the risk factors of lung transplantation in CTD patients to improve survival rates and reduce the risk of complications. This narrative review summarizes the selection and evaluation of candidates for CTD before lung transplantation and describes the clinical outcomes in CTD after lung transplantation in large‐capacity lung transplantation center. The purpose of this review is to help rheumatologists decide when to refer patients with CTD‐related lung involvement to a lung transplantation center and the conditions to consider before transplantation and to provide confidence to lung transplant experts.

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Connective tissue disease-associated interstitial lung disease and outcomes after hospitalization: A cohort study

Cited by 14 publications

References 18 publications

Causes of acute respiratory hospitalizations predict survival in fibrosing interstitial lung diseases

Causes of acute respiratory hospitalizations predict survival in fibrosing interstitial lung diseases

Causes of acute respiratory hospitalizations predict survival in fibrosing interstitial lung diseases

Lung Transplantation: A Viable Option for Connective Tissue Disease?

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