Evaluation of Incidental Exacerbation of Interstitial Pneumonia in Patients with non-Respiratory Dis
Introduction: Acute exacerbation of interstitial pneumonia often cause in inpatients with non-respiratory disease. The diagnosis and treatment are usually difficult and in-hospital mortality is high. However, there are only few studies demonstrating the factors of the disease prognosis.
Aims: To evaluate clinical features and the predictive factors of in-hospital mortality of the exacerbation of interstitial pneumonia in patients hospitalized for non-respiratory diseases.
Methods: Medical charts of inpatients referred to the Pulmonary Department for the exacerbation of interstitial pneumonia between 2010 and 2016 were retrospectively reviewed.
Results: In total, 33 patients (25 male and 8 female) were analyzed in this study. Average age of the patients was 68.4 (42-86). The types of the interstitial pneumonia were drug-induced pneumonia in 15 patients (45%), acute exacerbation of idiopathic interstitial pneumonia in 9 patients (27%), and acute exacerbation of interstitial lung disease associated with collagen-vascular disease in 4 patients (12%). In-hospital morality rate was 36%. Serum LDH elevations to more than 500 U/L at the onset of exacerbation was significantly associated with in-hospital mortality (p < 0.05); however, age, gender, and other laboratory data including Alb, KL-6, and CRP at the onset of exacerbation did not associate with in-hospital mortality. Further, the value of pulmonary function test such as FVC, FEV1.0 and DLCO/VA did not significantly correlate with in-hospital mortality.
Conclusions: Serum LDH elevations may be a surrogate marker for in-hospital mortality of exacerbation of interstitial pneumonia in patients hospitalized for non-respiratory diseases.