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...
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MDPI AG
2019-05-01
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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, 56–95 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) 1.022–1.141); <i>p</i> = 0.006), LDH (HR 1.003 (95% CI 1.000–1.006); <i>p</i> = 0.037), and total cholesterol (HR 0.985 (95% CI 0.972–0.997); <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. |
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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, 56–95 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) 1.022–1.141); <i>p</i> = 0.006), LDH (HR 1.003 (95% CI 1.000–1.006); <i>p</i> = 0.037), and total cholesterol (HR 0.985 (95% CI 0.972–0.997); <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 |
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