open access

Vol 89, No 2 (2021)
Research paper
Published online: 2021-04-21
Submitted: 2020-11-14
Accepted: 2020-12-28
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Risk factors for acute exacerbation following bronchoalveolar lavage in patients with suspected idiopathic pulmonary fibrosis: A retrospective cohort study

Mitsuhiro Abe, Kenji Tsushima, Daisuke Ishii, Kohei Shikano, Keiichiro Yoshioka, Masashi Sakayori, Masaki Suzuki, Yasutaka Hirasawa, Tsukasa Ishiwata, Takeshi Kawasaki, Jun Ikari, Jiro Terada, Koichiro Tatsumi
DOI: 10.5603/ARM.a2021.0012
·
Pubmed: 33881153
·
Adv Respir Med 2021;89(2):101-109.

open access

Vol 89, No 2 (2021)
ORIGINAL PAPERS
Published online: 2021-04-21
Submitted: 2020-11-14
Accepted: 2020-12-28

Abstract

Introduction: Bronchoalveolar lavage (BAL) is useful for diagnosing diffuse lung disease and excluding other conditions. However, acute exacerbations (AEs) are recognized as important complications of BAL in patients with idiopathic pulmonary fibrosis (IPF). This study aimed to identify risk factors for BAL-induced AEs in patients with IPF.
Material and methods: We retrospectively analyzed the data of 155 patients with suspected IPF who had undergone BAL between January 2013 and December 2018. BAL-related AE was defined as the development of AE within 30 days after the procedure. We compared clinical features and parameters between patients with AE (AE group) and without AE (non-AE group). We also reviewed the relevant reported literature.
Results: Among the 155 patients, 5 (3.2%) developed AE within 30 days after BAL. The average duration from BAL to AE onset was 7.8 days (2–16 days). Results from the univariate analysis revealed PaO2 < 75 mm Hg (p = 0.036), neutrophil content in BAL ≥ 7% (p = 0.0061), %DLCO < 50% (p = 0.019), Gender-Age-Physiology (GAP) stage III (p = 0.034), and BAL recovery rates < 30% (p < 0.001) as significant risk factors for post-BAL AE. All five patients who developed AE recovered and were discharged.
Conclusions: Disease severity, high neutrophil levels in BAL, and poor BAL recovery rates may be risk factors for BAL-induced AEs

Abstract

Introduction: Bronchoalveolar lavage (BAL) is useful for diagnosing diffuse lung disease and excluding other conditions. However, acute exacerbations (AEs) are recognized as important complications of BAL in patients with idiopathic pulmonary fibrosis (IPF). This study aimed to identify risk factors for BAL-induced AEs in patients with IPF.
Material and methods: We retrospectively analyzed the data of 155 patients with suspected IPF who had undergone BAL between January 2013 and December 2018. BAL-related AE was defined as the development of AE within 30 days after the procedure. We compared clinical features and parameters between patients with AE (AE group) and without AE (non-AE group). We also reviewed the relevant reported literature.
Results: Among the 155 patients, 5 (3.2%) developed AE within 30 days after BAL. The average duration from BAL to AE onset was 7.8 days (2–16 days). Results from the univariate analysis revealed PaO2 < 75 mm Hg (p = 0.036), neutrophil content in BAL ≥ 7% (p = 0.0061), %DLCO < 50% (p = 0.019), Gender-Age-Physiology (GAP) stage III (p = 0.034), and BAL recovery rates < 30% (p < 0.001) as significant risk factors for post-BAL AE. All five patients who developed AE recovered and were discharged.
Conclusions: Disease severity, high neutrophil levels in BAL, and poor BAL recovery rates may be risk factors for BAL-induced AEs

Get Citation

Keywords

bronchoalveolar lavage; C-reactive protein; idiopathic pulmonary fibrosis; interstitial lung disease; risk factor

About this article
Title

Risk factors for acute exacerbation following bronchoalveolar lavage in patients with suspected idiopathic pulmonary fibrosis: A retrospective cohort study

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 2 (2021)

Article type

Research paper

Pages

101-109

Published online

2021-04-21

DOI

10.5603/ARM.a2021.0012

Pubmed

33881153

Bibliographic record

Adv Respir Med 2021;89(2):101-109.

Keywords

bronchoalveolar lavage
C-reactive protein
idiopathic pulmonary fibrosis
interstitial lung disease
risk factor

Authors

Mitsuhiro Abe
Kenji Tsushima
Daisuke Ishii
Kohei Shikano
Keiichiro Yoshioka
Masashi Sakayori
Masaki Suzuki
Yasutaka Hirasawa
Tsukasa Ishiwata
Takeshi Kawasaki
Jun Ikari
Jiro Terada
Koichiro Tatsumi

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