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. 2021 Jun 28;7(2):00037-2021.
doi: 10.1183/23120541.00037-2021. eCollection 2021 Apr.

Body mass index and in-hospital mortality in patients with acute exacerbation of idiopathic pulmonary fibrosis

Nobuyasu Awano  1 , Taisuke Jo  2   3 , Hideo Yasunaga  4 , Minoru Inomata  1 , Naoyuki Kuse  1 , Mari Tone  1 , Kojiro Morita  4   5 , Hiroki Matsui  4 , Kiyohide Fushimi  6 , Takahide Nagase  3 , Takehiro Izumo  1
Affiliations

Body mass index and in-hospital mortality in patients with acute exacerbation of idiopathic pulmonary fibrosis

Nobuyasu Awano et al. ERJ Open Res. .

Abstract

Background: Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease characterised by chronic fibrosis, and acute exacerbation of IPF (AE-IPF) is the leading cause of death in patients with IPF. Data on the association between the body mass index (BMI) and prognosis of AE-IPF are lacking. This study was performed to evaluate the association between BMI and in-hospital mortality in patients who developed AE-IPF using a national inpatient database.

Methods: Using the Japanese Diagnosis Procedure Combination database, we retrospectively collected data of inpatients with AE-IPF from 1 July, 2010 to 31 March, 2018. We performed a multivariable logistic regression analysis to evaluate the association between all-cause in-hospital mortality and BMI, categorised as underweight (<18.5 kg·m-2), low-normal weight (18.5-22.9 kg·m-2), high-normal weight (23.0-24.9 kg·m-2), overweight (25.0-29.9 kg·m-2) and obese (≥30.0 kg·m-2).

Results: In total, 14 783 patients were eligible for this study. The in-hospital mortality rate was 59.0%, 55.0%, 53.8%, 54.8% and 46.0% in the underweight, low-normal weight, high-normal weight, overweight and obese groups, respectively. Underweight patients had a significantly higher mortality rate (OR 1.25, 95% CI 1.10-1.42) and obese patients had a significantly lower mortality rate (OR 0.71, 95% CI 0.54-0.94) than low-normal weight patients.

Conclusion: Among patients with AE-IPF, the underweight group had higher mortality and the obese group had lower mortality.

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Conflict of interest statement

Conflict of interest: N. Awano has nothing to disclose. Conflict of interest: T. Jo has nothing to disclose. Conflict of interest: H. Yasunaga reports grants from The Ministry of Health, Labour and Welfare, Japan, and The Ministry of Education, Culture, Sports, Science and Technology, Japan, during the conduct of the study. Conflict of interest: M. Inomata has nothing to disclose. Conflict of interest: N. Kuse has nothing to disclose. Conflict of interest: M. Tone has nothing to disclose. Conflict of interest: K. Morita has nothing to disclose. Conflict of interest: H. Matsui has nothing to disclose. Conflict of interest: K. Fushimi has nothing to disclose. Conflict of interest: T. Nagase has nothing to disclose. Conflict of interest: T. Izumo has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Flow chart of patient selection. #: idiopathic nonspecific interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, cryptogenic organising pneumonia, acute interstitial pneumonia, desquamative interstitial pneumonia, lymphoid interstitial pneumonia, idiopathic pleuroparenchymal fibroelastosis and unclassifiable idiopathic interstitial pneumonia.
FIGURE 2
FIGURE 2
All-cause in-hospital mortality in patients with acute exacerbation of idiopathic pulmonary fibrosis in relation to body mass index category.
See this image and copyright information in PMC

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