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Computed tomography findings in acute exacerbation of idiopathic pulmonary fibrosis
- Source :
- American journal of respiratory and critical care medicine. 178(4)
- Publication Year :
- 2008
-
Abstract
- The serial computed tomography findings and prognosis of the acute exacerbation of idiopathic pulmonary fibrosis (IPF) are not yet well defined in a larger number of cases.To evaluate the parenchymal abnormalities and prognosis using high-resolution computed tomography (HRCT) in acute exacerbation of IPF.The study consisted of clinical, laboratory, and HRCT data before and at the time of acute exacerbation in 64 episodes of 58 patients with IPF. A semiquantitative analysis of overall extent of parenchymal abnormalities, extent of alveolar opacity (ground-glass attenuation and consolidation), and extent of fibrotic opacity (reticulation and honeycombing) on CT was performed by two chest radiologists. The newly appeared parenchymal abnormalities were also classified into three patterns: peripheral, multifocal, and diffuse.In all patients, HRCT scans taken at the exacerbation showed typical signs of IPF and newly developing alveolar opacity. They included 34 patients of peripheral pattern, 8 of multifocal pattern, and 16 of diffuse pattern. Twenty-five patients died and 33 survived after the initial exacerbation. Worse survival was associated with patients with diffuse type compared with patients with multifocal and peripheral type. The CT patterns and overall CT extent were associated with an increased hazard of death after adjusting for age, sex, smoking, baseline diffusion capacity for carbon monoxide, baseline FVC, and disease extent on CT. On multivariate analysis, the strongest correlations were observed between CT patterns (combined diffuse and multifocal versus peripheral) and survival (odds ratio, 4.629; 95% confidence interval, 1.900-11.278; P = 0.001).HRCT extent and patterns are predictive of survival in acute exacerbation of IPF.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
Pathology
medicine.medical_specialty
Exacerbation
Pulmonary Fibrosis
Critical Care and Intensive Care Medicine
Idiopathic pulmonary fibrosis
Intensive care
Forced Expiratory Volume
Pulmonary fibrosis
medicine
Humans
Honeycombing
Hospital Mortality
Survival rate
Aged
Retrospective Studies
Aged, 80 and over
Respiratory Distress Syndrome
business.industry
Respiratory disease
Smoking
Retrospective cohort study
respiratory system
Middle Aged
medicine.disease
Prognosis
respiratory tract diseases
Bronchiectasis
Pulmonary Alveoli
Survival Rate
Acute Disease
Disease Progression
Female
Radiology
business
Respiratory Insufficiency
Tomography, Spiral Computed
Subjects
Details
- ISSN :
- 15354970
- Volume :
- 178
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- American journal of respiratory and critical care medicine
- Accession number :
- edsair.doi.dedup.....15524e68491356a165b003b62afc4ce7