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Open AccessArticle

Baseline High-Resolution CT Findings Predict Acute Exacerbation of Idiopathic Pulmonary Fibrosis: German and Japanese Cohort Study

1
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
2
Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-7551, Japan
3
Hiroshima Cosmopolitan University, Hiroshima 734-0014, Japan
4
Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
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Department of Diagnostic Radiology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima 737-0023, Japan
6
Interstitial and Rare Lung Disease Unit, Department of Pneumology, Ruhrlandklinik, University Hospital Essen, 45239 Essen, Germany
7
General and Experimental Pathology, Ruhr University Bochum, 44801 Bochum, Germany
8
Department of Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen, 45147 Essen, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2069; https://doi.org/10.3390/jcm8122069
Received: 30 October 2019 / Revised: 18 November 2019 / Accepted: 21 November 2019 / Published: 24 November 2019
(This article belongs to the Special Issue The New Frontier in Pulmonary Fibrosis)
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a major cause of morbidity and death in IPF. However, sensitive predictive factors of AE-IPF have not been well-investigated. To investigate whether high-resolution computed tomographic (HRCT) abnormalities predict AE-IPF in independent ethnic cohorts, this study included 121 patients with IPF (54 German and 67 Japanese; mean age, 68.5 ± 7.6 years). Two radiologists independently visually assessed the presence and extent of lung abnormalities in each patient. Twenty-two (18.2%) patients experienced AE-IPF during the follow-up. The incidence of AE-IPF was significantly higher in the Japanese patients (n = 18, 26.9%) than in the German patients (n = 4, 7.3%, p < 0.01). In the Kaplan–Meier analysis, patients with a larger extent of ground glass opacity (GGO), fibrosis, and traction bronchiectasis experienced an earlier onset of AE-IPF (p = 0.0033, 0.0088, and 0.049, respectively). In the multivariate analysis, a larger extent of GGO and fibrosis on HRCT were independent predictors of AE-IPF (p = 0.026 and 0.037, respectively). Additionally, Japanese ethnicity was independently associated with the incidence of AE-IPF after adjustment for HRCT findings (p = 0.0074). In conclusion, a larger extent of GGO and fibrosis on HRCT and Japanese ethnicity appear to be risk factors for AE-IPF. View Full-Text
Keywords: idiopathic pulmonary fibrosis (IPF); acute exacerbation (AE); high-resolution computed tomography (HRCT); ethnicity; ground glass opacity (GGO) idiopathic pulmonary fibrosis (IPF); acute exacerbation (AE); high-resolution computed tomography (HRCT); ethnicity; ground glass opacity (GGO)
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Hirano, C.; Ohshimo, S.; Horimasu, Y.; Iwamoto, H.; Fujitaka, K.; Hamada, H.; Kohno, N.; Komoto, D.; Awai, K.; Shime, N.; Bonella, F.; Guzman, J.; Kühl, H.; Costabel, U.; Hattori, N. Baseline High-Resolution CT Findings Predict Acute Exacerbation of Idiopathic Pulmonary Fibrosis: German and Japanese Cohort Study. J. Clin. Med. 2019, 8, 2069.

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