PT  - JOURNAL ARTICLE
AU  - Toru Arai
AU  - Yoshikazu Inoue
AU  - Chikatoshi Sugimoto
AU  - Kazunobu Tachibana
AU  - Yasushi Inoue
AU  - Tomoko Kagawa
AU  - Tomohisa Okuma
AU  - Masanori Akira
AU  - Masanori Kitaichi
AU  - Seiji Hayashi
TI  - Recent improvement of survival of acute exacerbation in idiopathic interstitial pneumonias: 10 years experience
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P755
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P755.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P755.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Introduction: Acute exacerbation (AE) in idiopathic interstitial pneumonias (IIPs) (AE-IIPs) has been widely accepted in Japan and it is a poor prognostic event in spite of multidisciplinary treatment.Aim: We examined AE-IIPs to clarify the survival change in these 10 years.Subjects: In our institute (KCCMC), 85 cases of AE-IIPs were diagnosed from 2004 to 2013 according to the guideline of Japanese Respiratory Society in 2004. We defined IPF as definite IPF diagnosed with surgical lung biopsy findings or clinical IPF diagnosed with definite UIP pattern on HRCT (ATS/ERS/JRS/ALAT guideline of IPF, AJRCCM 2011). HRCT findings of AE-IIPs were classified into diffuse or non-diffuse pattern (Akira, AJRCCM 2008). Subjects were divided into two groups according to diagnosis year of AE-IIPs, 2009-2013 (group A) and 2004-20008 (group B).Results: IPF (n=63) and Non-IPF (n=22) was examined. Treatment for AE-IIPs was steroid therapy (n=85), immunosuppressive drugs other than steroid (n=45), positive pressure ventilation (PPV) (n=35) and polymyxin B-immobilized fiber column (PMX) therapy (n=23). Survival of group A (n=42) was significantly better than that of group B (n=43){MST(days): 107 vs 35). There was no significant difference in treatments between group A and B, except for PMX therapy. AE-IIPs onset period, O2 inhalation before AE, HRCT pattern at AE (diffuse/non-diffuse) and PPV was significant poor prognostic factors by univariate Cox proportional hazard analysis. AE-IIPs onset period was a significant prognostic factor after the adjustment of the other three factors.Conclusions: Prognosis of AE-IIPs (2009-2013) improved as compared with AE-IIPs (2004-2008) in KCCMC.