title: Outcome of patients with idiopathic pulmonary fibrosis admitted to the intensive care unit.
abstract: This retrospective study describes the clinical course of 38 patients with idiopathic pulmonary fibrosis (IPF) admitted to the intensive care unit (ICU). There were 25 males and 13 females who were the mean age of 68.3 +/- 11.5 years. Twenty patients were on corticosteroids at the time of admission to the hospital, and 24 had been on home oxygen therapy. The most common reason for ICU admission was respiratory failure. The Acute Physiology and Chronic Health Evaluation III-predicted ICU and hospital mortality rates were 12% and 26%, whereas the actual ICU and hospital mortality rates were 45% and 61%, respectively. We did not find significant differences in pulmonary function or echocardiogram findings between survivors and nonsurvivors. Mechanical ventilation was used in 19 patients (50%). Sepsis developed in nine patients. Multiple organ failure developed in 14% of the survivors and in 43% of the nonsurvivors (p = 0.14). Ninety-two percent of the hospital survivors died at a median of 2 months after discharge. These findings suggest that patients with IPF admitted to the ICU have poor short- and long-term prognosis. Patients with IPF and their families should be informed about the overall outlook when they make decisions about life support and ICU care.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Saydain
authors.forename: Ashiq
authors.initials: A
authors.lastname: Islam
authors.forename: Bekele
authors.initials: B
authors.lastname: Afessa
authors.forename: Jay H
authors.initials: JH
authors.lastname: Ryu
authors.forename: John P
authors.initials: JP
authors.lastname: Scott
authors.forename: Steve G
authors.initials: SG
authors.lastname: Peters
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D016009:Chi-Square Distribution; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010102:Oxygen Inhalation Therapy; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy*; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones