Risk Factors For Interstitial Lung Disease Complicated With Respiratory Failure And Establishment Of Predictive Risk Model

ObjectiveTo explore the clinical symptoms,physiological and biochemical changes of interstitial lung disease complicated with respiratory failure,analyze the risk factors of ILD with RF,and establish a predictive risk model.MethodsTotally 291 Patients with ILD in The First Affiliated Hospital of Chongqing Medical University from January 2013 to January 2018,the patients were divided into case group and control group.The influencing factors of the two groups of patients in the hospital were analyzed.Logistic regression analysis was used to figure out the causes of respiratory failure in the patients with ILD.The Logistic regression model was evaluated using Hosmer-Lemeshow goodness of fit test and receiver operating characteristic(ROC).Results(1)Within 5 years,the mortality of cases group is 17.3%,apparentlyhigher than control group.(2)The significant differences were existed in smoking index,main symptoms,ALT,serum creatinine,CRP,D-Dimer,and whether complicated with chronic cardiovascular disease,pulmonary infection,or other chronic pulmonary disease(P<0.05),and the level of case group is higher.(3)The aggravated time of symptoms,serum albumin level is different(P<0.05),case group lower than control group.(4)The case group most show as IPF,when the control group mainly show as CTD-ILD(P<0.05).The HRCT of case group shows diffuse lesion,usually complicated with ground glass shadow(P<0.05).(5)There are no different in gender,age,BMI,permanent residence,pulmonary artery pressure between two groups.(6)Logistic regression analysis revealed that the aggravated time of symptoms,dyspnea,CRP,diffuse lesion and GGO in HRCT,cardiovascular disease,and pulmonary infection were independent risk factors.The area under the ROC curve for the evaluation model was 0.854(95%CI:0.805~0.903).The sensitivity of Logistic regression model is67.1%,specificity is 89.5%.ConclusionsMore attention should be paid to the ILD patients who have an acute exacerbation in short time,dyspnea,companying with high CRP level,diffuse lesion and ground-glass opacity,combined with cardiovasculardisease or pulmonary infection.Because such patients may be associated with RF,and the mortality is high,the final outcome is poor.The risk model might be an effective tool for predicting whether there will be respiratory failure of ILD patients.