Pulmonary infections following immunosuppressive treatments during hospitalization worsen the short-term vital prognosis for patients with connective tissue disease-associated interstitial pneumonia.
OBJECTIVE
Connective tissue disease-associated interstitial pneumonia (CTD-IP) significantly affects the mortality of patients with CTD. The purpose of the present study is to identify causes and risk factors for death during hospitalization for immunosuppressive treatment of CTD-IP.


METHODS
A multicenter, retrospective study was conducted that collected data from patients with CTD who had been hospitalized for commencing or intensifying immunosuppressive treatment of CTD-IP using a standardized case report form. Risk factors were identified using the Cox proportional hazard regression model.


RESULTS
A total of 322 CTD-IP patients were enrolled with rheumatoid arthritis (n = 84), systemic lupus erythematosus (n = 13), polymyositis (n = 33), dermatomyositis (n = 69), systemic sclerosis (n = 55), mixed connective tissue disease (n = 21), microscopic polyangiitis (n = 19), and overlap syndrome (n = 28). Of the 42 patients who died during hospitalization, 22 died from CTD-IP, 15 from CTD-IP and pulmonary infection, 2 from pulmonary infection, and 3 from other causes. Age ≥ 65 years and development of pulmonary infections after commencing or intensifying immunosuppressive treatments were identified as risk factors for death during hospitalization after adjusting for covariates.


CONCLUSION
Careful consideration of the benefit-risk balance of immunosuppressive treatment for CTD-IP is indispensable for improving the short-term vital prognosis of these patients.
['Tanaka|Michi|M|', 'Koike|Ryuji|R|', 'Sakai|Ryoko|R|', 'Saito|Kazuyoshi|K|', 'Hirata|Shintaro|S|', 'Nagasawa|Hayato|H|', 'Kameda|Hideto|H|', 'Hara|Masako|M|', 'Kawaguchi|Yasushi|Y|', 'Tohma|Shigeto|S|', 'Takasaki|Yoshinari|Y|', 'Dohi|Makoto|M|', 'Nishioka|Yasuhiko|Y|', 'Yasuda|Shinsuke|S|', 'Miyazaki|Yasunari|Y|', 'Kaneko|Yuko|Y|', 'Nanki|Toshihiro|T|', 'Watanabe|Kaori|K|', 'Yamazaki|Hayato|H|', 'Miyasaka|Nobuyuki|N|', 'Harigai|Masayoshi|M|']
D000293:Adolescent D000328:Adult D000368:Aged D003240:Connective Tissue Diseases D005260:Female D005500:Follow-Up Studies D017052:Hospital Mortality D006760:Hospitalization D006801:Humans D007166:Immunosuppressive Agents D007564:Japan D017563:Lung Diseases, Interstitial D008297:Male D008875:Middle Aged D011379:Prognosis D012141:Respiratory Tract Infections D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D015996:Survival Rate D013997:Time Factors
Pulmonary infections Immunosuppressive treatments Vital prognosis Interstitial pneumonia Connective tissue disease