RT Journal Article
SR Electronic
T1 Survival from acute exacerbation of idiopathic pulmonary fibrosis with or without direct hemoperfusion with polymyxin B-immobilized fiber column: A retrospective analysis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2101
DO 10.1183/13993003.congress-2016.PA2101
VO 48
IS suppl 60
A1 Keiji Oishi
A1 Keisuke Aoe
A1 Yusuke Mimura
A1 Yoriyuki Murata
A1 Kenji Sakamoto
A1 Wataru Koutoku
A1 Tsuneo Matsumoto
A1 Hiroshi Ueoka
A1 Kazuto Mastunaga
A1 Masafumi Yano
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA2101.abstract
AB Background: Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are fatal episodes of acute respiratory worsening of unknown etiology. Previous studies on acute respiratory distress syndrome have shown that direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP) beneficially impact respiratory status.Aimes: To investigate the prognosis and survival outcome of patients with AE-IPF who underwent PMX-DHP.Methods: We examined records of 50 patients with AE-IPF treated in our hospital. All patients received corticosteroid pulse therapy. We compared the disease outcome between 27 patients who underwent PMX-DHP (PMX group) and 23 patients who did not (non-PMX group). Independent predictors of survival were determined with Cox proportional hazards analyses.Results: A multivariate analysis of all patients revealed that PMX-DHP therapy was a significant predictor of survival (HR=0.442, p=0.019). Throughout the median observational period of 42.0 days (range, 1-1656 days) 38 patients (76.0%) died. Overall survival was significantly longer in the PMX group than the non-PMX group: median survival time, 192 days in the PMX vs. 29 days in the non-PMX (p=0.040, log rank test). The 12-month survival rate was also significantly better in the PMX group than the non-PMX group (41.7% vs. 9.8%). In a subanalysis of the PMX group, time from AE-IPF onset to PMX-DHP was a significant predictor of survival (HR=1.080, p=0.049).Conclusions: PMX-DHP improved the prognosis of AE-IPF. Time from AE-IPF onset to PMX-DHP may be informative for outcome prediction.