한빛사논문
- 조회245
Byoung Soo Kwon MDa, Ho Young Lee MDb,e, Jooae Choe MD, PhDc, Eun Jin Chae MD, PhDc, Seokchan Hong MD, PhDd, Jin Woo Song MD, PhDb*
aDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea
bDepartment of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
cDepartment of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
dDepartment of Rheumatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
eDepartment of Pulmonary and Critical Care Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Pusan, Republic of Korea
*Corresponding author.
Abstract
Background
Interstitial lung disease (ILD) is associated with increased morbidity and mortality in rheumatoid arthritis (RA). Moreover, acute exacerbation (AE) is a devastating complication of RA plus ILD. However, few data on AE in RA-associated ILD are available.
Research Question
What are the incidence, risk factors, and outcomes of AE in patients with RA-associated ILD?
Study Design and Methods
The clinical data of 310 patients with RA-associated ILD were analyzed retrospectively. AE was defined as the acute worsening of dyspnea typically within 30 days with new bilateral lung infiltration, which was based on a 2016 report by an international working group.
Results
The mean age of the participants was 61.9 years, and 56.2% of them were women. During follow-up (median, 47.7 months), AE occurred in 87 patients (28.1%). The 1-year, 3-year, and 5-year cumulative incidence rates of AE in patients with RA-associated ILD were 9.2%, 19.8%, and 29.4%, respectively. Ever smoker status, lower FVC, and shorter 6-min walk distance were significant risk factors for the occurrence of AE. In the multivariate Cox analysis adjusted by age, sex, smoking status, lung function, exercise capacity, and high-resolution CT scan pattern, AE was a significant prognostic factor for overall survival (hazard ratio, 2.423; 95% CI, 1.605-3.660; P < .001) in patients with RA-associated ILD. The 30-day and 90-day mortalities after AE were 12.6% and 29.9%, respectively.
Interpretation
Our findings suggest that approximately one-third of patients with RA-associated ILD experience AE and that ever smoker status, and lower lung function and exercise capacity predispose patients to AE. AE significantly affects the overall survival of patients with RA-associated ILD.
논문정보
- Research article
- 2022년 01월 (BRIC 등록일 2022-04-12)
- 국내 연구진
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