Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2026
In-hospital Mortality Associated with Granulomatosis with Polyangiitis and Microscopic Polyangiitis Complicated with Respiratory Failure.
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Costa Filho Francisco F, Motiani Vanita, Furlan Alan, Brubaker Austin S, Kidambi Pranav, Kroth Philip
Аннотация
BACKGROUND AND AIM: Our study aimed to determine the in-hospital mortality rate among granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) hospitalizations complicated with acute respiratory failure (ARF) in the US and determine prognostic factors during hospitalization.
METHOD: We performed a retrospective cohort analysis utilizing the National In-patient Sample (NIS) database to identify hospitalizations of patients with GPA or MPA associated with ARF from 2016 to 2021. The outcomes included in-hospital mortality, requirement of invasive procedures, and hospital length of stay. Univariable and multivariable analysis were used to identify prognostic factors associated with in-hospital mortality.
RESULTS: We identified 21,430 weighted (4,283 unweighted) hospitalizations with diagnosis of GPA or MPA associated with ARF in the United States from 2016 to 2021. 78.3% of those were diagnosed with GPA, 19.2% with MPA, and 2.5% with both ICD-10 codes. The mean age was 63.7 years, 53.6% were female, and 73.3% were White. The rate of hemodialysis was 21.5%, plasmapheresis 7.4%, and extracorporeal membrane oxygenation in 0.5% of hospitalizations. The overall in-hospital mortality was 15.4%, compared to 35.9% in the subgroup requiring invasive mechanical ventilation (IMV). Independent prognostic factors associated with increased in-hospital mortality were higher age, acute kidney injury (AKI), sepsis, requirement of non-invasive mechanical ventilation, interstitial lung disease (ILD), history of stroke, shock, and requirement of IMV.
CONCLUSION: GPA or MPA hospitalizations complicated with ARF were found to be associated with a high in-hospital mortality rate. At hospital-level prognostication assessment, we found that higher age, AKI, sepsis, shock, history of ILD, history of stroke, and requirement of mechanical ventilation were independently associated with increased in-hospital mortality.
METHOD: We performed a retrospective cohort analysis utilizing the National In-patient Sample (NIS) database to identify hospitalizations of patients with GPA or MPA associated with ARF from 2016 to 2021. The outcomes included in-hospital mortality, requirement of invasive procedures, and hospital length of stay. Univariable and multivariable analysis were used to identify prognostic factors associated with in-hospital mortality.
RESULTS: We identified 21,430 weighted (4,283 unweighted) hospitalizations with diagnosis of GPA or MPA associated with ARF in the United States from 2016 to 2021. 78.3% of those were diagnosed with GPA, 19.2% with MPA, and 2.5% with both ICD-10 codes. The mean age was 63.7 years, 53.6% were female, and 73.3% were White. The rate of hemodialysis was 21.5%, plasmapheresis 7.4%, and extracorporeal membrane oxygenation in 0.5% of hospitalizations. The overall in-hospital mortality was 15.4%, compared to 35.9% in the subgroup requiring invasive mechanical ventilation (IMV). Independent prognostic factors associated with increased in-hospital mortality were higher age, acute kidney injury (AKI), sepsis, requirement of non-invasive mechanical ventilation, interstitial lung disease (ILD), history of stroke, shock, and requirement of IMV.
CONCLUSION: GPA or MPA hospitalizations complicated with ARF were found to be associated with a high in-hospital mortality rate. At hospital-level prognostication assessment, we found that higher age, AKI, sepsis, shock, history of ILD, history of stroke, and requirement of mechanical ventilation were independently associated with increased in-hospital mortality.