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

Abstract

BackgroundIdiopathic 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 the BMI and in-hospital mortality in patients who developed AE-IPF using a national inpatient database.MethodsUsing the Japanese Diagnosis Procedure Combination database, we retrospectively collected data of inpatients with AE-IPF from July 1, 2010 to March 31, 2018. We performed a multivariable logistic regression analysis to evaluate the association between all-cause in-hospital mortality and the 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).ResultsIn 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 (odds ratio, 1.25; 95% confidence interval, 1.10–1.42) and obese patients had a significantly lower mortality rate (odds ratio, 0.71; 95% confidence interval, 0.54–0.94) than low-normal weight patients.ConclusionAmong patients with AE-IPF, the underweight group had higher mortality and the obese group had lower mortality.