AI Article Synopsis
- The study investigates the impact of pre-existing interstitial lung disease (ILD) on the outcomes of non-HIV pneumonia patients, finding that those with ILD have significantly higher 90-day mortality rates.
- The results highlight that higher neutrophil percentages in bronchoalveolar lavage fluid correlate with worse outcomes, and low serum albumin levels are identified as independent risk factors for mortality.
- The conclusion emphasizes the need for preventative measures against pneumonia in immunocompromised individuals with existing ILD due to their increased risk.
Article Abstract
Background: The increasing incidence of life-threatening pneumonia (PCP) in non-HIV immunocompromised patients is a global concern. Yet, no reports have examined the prognostic significance of pre-existing interstitial lung disease (ILD) in non-HIV PCP.
Methods: We retrospectively reviewed the medical records of non-HIV PCP patients with (ILD group) or without (non-ILD group) pre-existing ILD. The clinical features and outcomes of the ILD group were compared with those of the non-ILD group. Cox regression models were constructed to identify prognostic factors.
Results: 74 patients were enrolled in this study. The 90-day mortality was significantly higher in the ILD group than in the non-ILD group (62.5% 19.0%, p<0.001). In the ILD group, patients with a higher percentage of bronchoalveolar lavage fluid neutrophils had worse outcomes compared to those having a lower percentage (p=0.026). Multivariate analyses revealed that pre-existing ILD (p=0.002) and low levels of serum albumin (p=0.009) were independent risk factors for 90-day mortality. Serum levels of β-d-glucan were significantly reduced after treatment of PCP in both groups, whereas levels of Krebs von den Lungen-6 (KL-6) significantly increased in the ILD group. In the ILD group, the 90-day mortality of patients with increasing KL-6 levels after treatment was significantly higher than those with decreasing levels (78.9% 0%, p=0.019).
Conclusion: In non-HIV PCP patients, pre-existing ILD is associated with a poorer prognosis. Prophylaxis for PCP is needed in patients with pre-existing ILD under immunosuppression.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196667 | PMC |
| http://dx.doi.org/10.1183/23120541.00306-2019 | DOI Listing |
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