Page 91 - Livre électronique des RFTP 2023

P53. CAN WE PREDICT SEVERITY OF ACUTE

EXACERBATION IN INTERSTIAL LUNG DISEASE?

W. JELASSI1, A. HEDHLI1, N. H. KHEZAMI1, K. EUCHI1, Y. OUAHCHI1, S. TOUJANI1, S.
CHEIKHROUHOU1, M. MJID1, B. DHAHRI1.

1TUNIS EL MANAR UNIVERSITY, FACULTY OF MEDICINE OF TUNIS, LA RABTA HOSPITAL,
PULMONOLOGYDEPARTMENT, LR18SP02, TUNIS, TUNISIA

INTRODUCTION : The term acute exacerbation of interstitial lung disease (ILD)
refers to a deterioration that occurs suddenly and clinically in a way that is
significant within a month but has no apparent medical explanation. Idiopathic
pulmonary fibrosis (IPF) acute exacerbations have been the subject of numerous
investigations, but less is known about similar occurrences in other ILDs that could
have a progressive-fibrosing pattern.

The aim of this study is to determine predicting factors of acute exacerbation of
interstitial lung disease (AE-ILD).

METHODS : A descriptive study was conducted on 64 patients followed for
confirmed ILD in our pulmonology department in La Rabta teaching hospital from
January 2018 until April 2023. Sociodemographic information, clinical, spirometric
and radiological features as well as blood test results were collected from medical
records.

RESULTS : Our population consisted of 35 (54,7%) men and 29 (45,3%) women. The
mean age was 67,70 +- 11,27 years. The distribution of ILD sub types was as follows:
33 (51,6%) patients had Idiopathic pulmonary fibrosis (IPF), 10 (15,6%) patients had
connective tissue-associated ILD (CTD-ILD), 7 (10%) patients had non-specific
interstitial lung disease, 12 (18,8%) had pulmonary sarcoidosis and 1 (1,6%) patient
had chronic hypersensitivity pneumonitis (CHP).

The median length of follow up was 30,22 months (IQR: 4,22 - 56,2 months ). Thirty-
three (51,6%) patients had AE-ILD, 39 (60%) patients had a significant decline in CVF
of more than 10% and 18 (28,1%) patients died. The desaturation in the 6-minute
walk test, the development of fibrosis, and the chronic respiratory failure were
strongly correlated with frequent AE-ILD (r=0,565, p=0,04; r=,334, p=0,01 and r=0,56,
p<10-3 respectively). Fibrosis and Declin in FVC of more than 10% were correlated
with the risk of hospitalisation for AE-ILD due to acute respiratory failure (r=0,37,
p=0,001 and r= ,377, p=0,001). IPF was the sub type that was the most associated
with death due to AE-ILD (p=0,01).

CONCLUSION : Acute exacerbations of interstitial lung disease are a serious
condition with a high rate of in-hospital mortality. The clinical course seems to be
more fatal in IPF compared to non-IPF ILD.

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