Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis

<i>Background and objectives:</i> Idiopathic pulmonary fibrosis (IPF) has a particularly poor prognosis, and most IPF-related deaths are due to acute exacerbation (AE) of this condition. Few reports about biomarkers to predict prognosis of AE-IPF have been published since the release of...

Full description

Bibliographic Details
Main Authors: Yoshimasa Hachisu, Keisuke Murata, Kousuke Takei, Takuma Tsuchiya, Hiroaki Tsurumaki, Yasuhiko Koga, Takeo Horie, Atsushi Takise, Takeshi Hisada
Format: Article
Language:English
Published: MDPI AG 2019-05-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1010-660X/55/5/132
_version_ 1827835705865273344
author Yoshimasa Hachisu
Keisuke Murata
Kousuke Takei
Takuma Tsuchiya
Hiroaki Tsurumaki
Yasuhiko Koga
Takeo Horie
Atsushi Takise
Takeshi Hisada
author_facet Yoshimasa Hachisu
Keisuke Murata
Kousuke Takei
Takuma Tsuchiya
Hiroaki Tsurumaki
Yasuhiko Koga
Takeo Horie
Atsushi Takise
Takeshi Hisada
author_sort Yoshimasa Hachisu
collection DOAJ
description <i>Background and objectives:</i> Idiopathic pulmonary fibrosis (IPF) has a particularly poor prognosis, and most IPF-related deaths are due to acute exacerbation (AE) of this condition. Few reports about biomarkers to predict prognosis of AE-IPF have been published since the release of the new AE-IPF criteria in 2016. The present study investigated relationships between serological markers and in-hospital mortality after the onset of AE-IPF. <i>Methods:</i> Demographic, serological, and imaging data from patients hospitalized at the Maebashi Red Cross Hospital (Gunma, Japan) between 1 January 2013, and 31 December 2017, were retrospectively reviewed. Subjects fulfilling the diagnostic criteria for AE-IPF were divided into those who survived or died; statistical analysis of risk factors was performed using data from these two groups. <i>Results:</i> Diagnostic criteria for AE-IPF were fulfilled by 84 patients (59 males (70.2%)), with a median age of 78 years (range, 56&#8211;95 years). IPF was diagnosed before hospitalization in 50 (59.5%) patients and 38 (45.2%) died in hospital. Among the serological markers at hospitalization in the deceased group, C-reactive protein (CRP) was significantly higher than in the survivor group (<i>p</i> = 0.002), while total serum protein (<i>p</i> = 0.031), albumin (<i>p</i> = 0.047) and total cholesterol (<i>p</i> = 0.039) were significantly lower. Cox hazard analysis of factors predicting mortality, corrected for age, sex and BMI, revealed the following: CRP (hazard ratio (HR) 1.080 (95% confidence interval (CI) 1.022&#8211;1.141); <i>p</i> = 0.006), LDH (HR 1.003 (95% CI 1.000&#8211;1.006); <i>p</i> = 0.037), and total cholesterol (HR 0.985 (95% CI 0.972&#8211;0.997); <i>p</i> = 0.018). <i>Conclusions:</i> Our data suggest that CRP, LDH, and total cholesterol may be biomarkers predicting mortality in patients with AE-IPF. However, only prospective controlled studies can confirm or not our observation as a generalizable one.
first_indexed 2024-03-12T06:13:58Z
format Article
id doaj.art-b1650f2069b040c7a0d2e178065c696d
institution Directory Open Access Journal
issn 1010-660X
language English
last_indexed 2024-03-12T06:13:58Z
publishDate 2019-05-01
publisher MDPI AG
record_format Article
series Medicina
spelling doaj.art-b1650f2069b040c7a0d2e178065c696d2023-09-03T02:47:37ZengMDPI AGMedicina1010-660X2019-05-0155513210.3390/medicina55050132medicina55050132Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary FibrosisYoshimasa Hachisu0Keisuke Murata1Kousuke Takei2Takuma Tsuchiya3Hiroaki Tsurumaki4Yasuhiko Koga5Takeo Horie6Atsushi Takise7Takeshi Hisada8Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, JapanDepartment of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, JapanDepartment of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, JapanDepartment of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, JapanDepartment of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, JapanDepartment of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, JapanDepartment of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, JapanDepartment of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, JapanGunma University Graduate School of Health Sciences, 3-39-22, Showa-machi, Maebashi, Gunma 371-8514, Japan<i>Background and objectives:</i> Idiopathic pulmonary fibrosis (IPF) has a particularly poor prognosis, and most IPF-related deaths are due to acute exacerbation (AE) of this condition. Few reports about biomarkers to predict prognosis of AE-IPF have been published since the release of the new AE-IPF criteria in 2016. The present study investigated relationships between serological markers and in-hospital mortality after the onset of AE-IPF. <i>Methods:</i> Demographic, serological, and imaging data from patients hospitalized at the Maebashi Red Cross Hospital (Gunma, Japan) between 1 January 2013, and 31 December 2017, were retrospectively reviewed. Subjects fulfilling the diagnostic criteria for AE-IPF were divided into those who survived or died; statistical analysis of risk factors was performed using data from these two groups. <i>Results:</i> Diagnostic criteria for AE-IPF were fulfilled by 84 patients (59 males (70.2%)), with a median age of 78 years (range, 56&#8211;95 years). IPF was diagnosed before hospitalization in 50 (59.5%) patients and 38 (45.2%) died in hospital. Among the serological markers at hospitalization in the deceased group, C-reactive protein (CRP) was significantly higher than in the survivor group (<i>p</i> = 0.002), while total serum protein (<i>p</i> = 0.031), albumin (<i>p</i> = 0.047) and total cholesterol (<i>p</i> = 0.039) were significantly lower. Cox hazard analysis of factors predicting mortality, corrected for age, sex and BMI, revealed the following: CRP (hazard ratio (HR) 1.080 (95% confidence interval (CI) 1.022&#8211;1.141); <i>p</i> = 0.006), LDH (HR 1.003 (95% CI 1.000&#8211;1.006); <i>p</i> = 0.037), and total cholesterol (HR 0.985 (95% CI 0.972&#8211;0.997); <i>p</i> = 0.018). <i>Conclusions:</i> Our data suggest that CRP, LDH, and total cholesterol may be biomarkers predicting mortality in patients with AE-IPF. However, only prospective controlled studies can confirm or not our observation as a generalizable one.https://www.mdpi.com/1010-660X/55/5/132acute exacerbationidiopathic pulmonary fibrosismortalityCRPLDHtotal cholesterol
spellingShingle Yoshimasa Hachisu
Keisuke Murata
Kousuke Takei
Takuma Tsuchiya
Hiroaki Tsurumaki
Yasuhiko Koga
Takeo Horie
Atsushi Takise
Takeshi Hisada
Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
Medicina
acute exacerbation
idiopathic pulmonary fibrosis
mortality
CRP
LDH
total cholesterol
title Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
title_full Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
title_fullStr Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
title_full_unstemmed Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
title_short Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
title_sort possible serological markers to predict mortality in acute exacerbation of idiopathic pulmonary fibrosis
topic acute exacerbation
idiopathic pulmonary fibrosis
mortality
CRP
LDH
total cholesterol
url https://www.mdpi.com/1010-660X/55/5/132
work_keys_str_mv AT yoshimasahachisu possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT keisukemurata possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT kousuketakei possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT takumatsuchiya possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT hiroakitsurumaki possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT yasuhikokoga possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT takeohorie possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT atsushitakise possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis
AT takeshihisada possibleserologicalmarkerstopredictmortalityinacuteexacerbationofidiopathicpulmonaryfibrosis