Risk factors for mortality and mortality rates in interstitial lung disease patients in the intensive care unit. [Review]

MedStar author(s):
Citation: European Respiratory Review. 27(150), 2018 Dec 31.PMID: 30463873Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Hospital Mortality/td [Trends] | *Intensive Care Units | *Lung Diseases, Interstitial/mo [Mortality] | Age Factors | APACHE | Humans | Hypoxia/mo [Mortality] | Hypoxia/th [Therapy] | Lung Diseases, Interstitial/di [Diagnosis] | Lung Diseases, Interstitial/th [Therapy] | Prognosis | Respiration, Artificial/ae [Adverse Effects] | Respiration, Artificial/mo [Mortality] | Risk Assessment | Risk Factors | Steroids/tu [Therapeutic Use] | Time FactorsYear: 2018Local holdings: Available online through MWHC library: September 2005 - presentISSN:
  • 0905-9180
Name of journal: European respiratory review : an official journal of the European Respiratory SocietyAbstract: Copyright (c)ERS 2018.Data on interstitial lung disease (ILD) outcomes in the intensive care unit (ICU) is of limited value due to population heterogeneity. The aim of this study was to examine risk factors for mortality and ILD mortality rates in the ICU.We performed a systematic review using five databases. 50 studies were identified and 34 were included: 17 studies on various aetiologies of ILD (mixed-ILD) and 17 on idiopathic pulmonary fibrosis (IPF). In mixed-ILD, elevated APACHE score, hypoxaemia and mechanical ventilation are risk factors for mortality. No increased mortality was found with steroid use. Evidence is inconclusive on advanced age. In IPF, evidence is inconclusive for all factors except mechanical ventilation and hypoxaemia. The overall in-hospital mortality was available in 15 studies on mixed-ILD (62% in 2001-2009 and 48% in 2010-2017) and 15 studies on IPF (79% in 1993-2004 and 65% in 2005-2017). Follow-up mortality rate at 1 year ranged between 53% and 100%.Irrespective of ILD aetiology, mechanical ventilation is associated with increased mortality. For mixed-ILD, hypoxaemia and APACHE scores are also associated with increased mortality. IPF has the highest mortality rate among ILDs, but since 1993 the rate appears to be declining. Despite improving in-hospital survival, overall mortality remains high.All authors: Brower RG, Danoff SK, Harden CT, Huapaya JA, Wilfong EMFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2018-12-14
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30463873 Available 30463873

Available online through MWHC library: September 2005 - present

Copyright (c)ERS 2018.

Data on interstitial lung disease (ILD) outcomes in the intensive care unit (ICU) is of limited value due to population heterogeneity. The aim of this study was to examine risk factors for mortality and ILD mortality rates in the ICU.We performed a systematic review using five databases. 50 studies were identified and 34 were included: 17 studies on various aetiologies of ILD (mixed-ILD) and 17 on idiopathic pulmonary fibrosis (IPF). In mixed-ILD, elevated APACHE score, hypoxaemia and mechanical ventilation are risk factors for mortality. No increased mortality was found with steroid use. Evidence is inconclusive on advanced age. In IPF, evidence is inconclusive for all factors except mechanical ventilation and hypoxaemia. The overall in-hospital mortality was available in 15 studies on mixed-ILD (62% in 2001-2009 and 48% in 2010-2017) and 15 studies on IPF (79% in 1993-2004 and 65% in 2005-2017). Follow-up mortality rate at 1 year ranged between 53% and 100%.Irrespective of ILD aetiology, mechanical ventilation is associated with increased mortality. For mixed-ILD, hypoxaemia and APACHE scores are also associated with increased mortality. IPF has the highest mortality rate among ILDs, but since 1993 the rate appears to be declining. Despite improving in-hospital survival, overall mortality remains high.

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