Risk factors for mortality and mortality rates in interstitial lung disease patients in the intensive care unit

Julio A. Huapaya, Erin M. Wilfong, Christopher T. Harden, Roy G Brower, Sonye Danoff

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
JournalEuropean respiratory review : an official journal of the European Respiratory Society
Volume27
Issue number150
DOIs
StatePublished - Dec 31 2018

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Interstitial Lung Diseases
Intensive Care Units
Mortality
Idiopathic Pulmonary Fibrosis
Artificial Respiration
APACHE
Population Characteristics
Hospital Mortality
Steroids
Databases
Survival

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Risk factors for mortality and mortality rates in interstitial lung disease patients in the intensive care unit. / Huapaya, Julio A.; Wilfong, Erin M.; Harden, Christopher T.; Brower, Roy G; Danoff, Sonye.

In: European respiratory review : an official journal of the European Respiratory Society, Vol. 27, No. 150, 31.12.2018.

Research output: Contribution to journalReview article

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