| アブストラクト | BACKGROUND: Acute exacerbations of idiopathic interstitial pneumonias (AE-IIPs) are life-threatening events. However, comparative prognostic data across IIP subtypes during AE are limited. This study aimed to evaluate in-hospital mortality differences among major AE-IIP subtypes using a nationwide database in Japan. METHODS: We retrospectively analysed patients with AE of idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia (NSIP), cryptogenic organising pneumonia (COP), or acute interstitial pneumonia (AIP) who received high-dose methylprednisolone between 1 July, 2010 and 31 March, 2023. Data were extracted from the Japanese Diagnosis Procedure Combination database. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included 14- and 28-day mortality. Multivariable logistic regression analysis with generalised estimating equations was employed to adjust for potential confounders, incorporating multiple imputation to address missing data. RESULTS: A total of 6645 patients were included (IPF, n = 2092; NSIP, n = 581; COP, n = 871; AIP, n = 3101). Unadjusted in-hospital mortality rates were 53.9 % for IPF, 40.1 % for NSIP, 17.6 % for COP, and 49.3 % for AIP. After adjustment, in-hospital mortality was significantly higher for IPF (odds ratio [OR], 3.92; 95 % confidence interval [95 % CI], 3.05-5.04; p < 0.001), NSIP (OR, 2.80; 95 % CI, 2.10-3.73; p < 0.001), and AIP (OR, 3.07; 95 % CI, 2.43-3.89; p < 0.001), compared with COP. Similar trends were observed for both secondary outcomes. CONCLUSIONS: Among patients with AE-IIPs, those with IPF, NSIP, and AIP exhibited significantly higher in-hospital mortality compared with COP. These findings underscore the inferior prognosis associated with AE-IPF and AIP. |
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| ジャーナル名 | Respiratory investigation |
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| Pubmed追加日 | 2025/10/8 |
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| 投稿者 | Awano, Nobuyasu; Aso, Shotaro; Izumo, Takehiro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22;Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address:;awanobu0606@hotmail.co.jp.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.;Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.;Department of Health Policy and Informatics, Institute of Science, 1-5-45;Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41056590/ |
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