ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Comparative Analysis of the Therapy for Patients with Interstitial Lung Disease Hospitalised to a General Hospital

DOI:10.31550/1727-2378-2020-19-5-60-66
Bibliography link: Shakirova G.R., Shavaliev R.F., Gizatullina E.D., Vizel I.Yu. Comparative Analysis of the Therapy for Patients with Interstitial Lung Disease Hospitalised to a General Hospital. Doctor.Ru. 2020; 19(5): 60–66. (in Russian) DOI: 10.31550/1727-2378-2020- 19-5-60-66
22 July 19:26

Study Objective: analysis of comprehensive examination results of patients with interstitial lung disease (ILD) hospitalised to the National Clinical Hospital of the Ministry of Health of the Republic of Tatarstan.

Study Design: retrospective analytical study.

Materials and Methods. Medical records of 112 patients with newly diagnosed ILD were analysed. Information included analysis, results of complete physical examination of organs and systems, full blood count, urinalysis, X-ray examinations, saturation at rest and after a 6-minute walk, and forced expiratory volume.

Study Results. All subjects were divided into three groups. Group 1 was 65 patients with granulomatous diseases including sarcoidosis; group 2 — 24 patients with idiopathic interstitial pneumonia (IIP); group 3 — 23 patients with a known ILD. Females prevailed in all groups. The primary diagnostic method was X-ray computed tomography. Histology confirmation was required mostly in sarcoidosis (72.3%). The poorest ventilation capacity was in patients with a known ILD. ILD therapy was diagnosis dependant. Systematic glucocorticosteroids were prescribed to 10.8% of sarcoidosis patients, 83.3% of patients with IIP (100% patients with nonspecific interstitial pneumonia and cryptogenic organizing pneumonia), 82.6% of patients with ILD in combination with systemic connective tissue disorders and exogenous allergic alveolitis.

Conclusion. Analysis demonstrated that during diagnosis, medical professionals face some challenges (due to underscored importance of respiratory function examination) and not always reasonably prescribe antimicrobials or short glucocorticosteroids courses prior to hospitalisation. Phthisiology vigilance and tuberculin diagnostics were present in sarcoidosis and were clearly insufficient in other ILDs. Any further actions taken by medical staff were within the boundaries of the modern approaches to ILD management and complied with the national respiratory medicine guidelines. In a multidisciplinary medical facility, ILD patients are offered quality medical aid; three-tier aid system facilitates reduction step-wise routing, and a correct disease is diagnosed without delays.

Contributions: Shakirova, G.R. — collection of primary data, database maintenance, primary statistic processing, text; Shavaliev, R.F. — practicality analysis and correction of content, material collection management; Gizatullina, E.D. — collection of primary data, database maintenance, generation of charts; Vizel, I.Yu. — text, translation of literature sources.

Conflict of interest: The authors declare that they do not have any conflict of interests.

G.R. Shakirova (Corresponding author) — Kazan State Medical University of the Ministry of Health of the Russian Federation; 49 Butlerov Str., Kazan, Russian Federation 420012. National Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; 138 Orenburg trakt, Kazan, Russian Federation 420064. E-mail: adeleashakirova02@mail.ru

R.F. Shavaliev — National Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; 138 Orenburg trakt, Kazan, Russian Federation 420064. E-mail: mz.rkb@tatar.ru

E.D. Gizatullina — Kazan State Medical University of the Ministry of Health of the Russian Federation; 49 Butlerov Str., Kazan, Russian Federation 420012. National Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; 138 Orenburg trakt, Kazan, Russian Federation 420064. E-mail: gizatullinaelia@yandex.ru

I.Yu. Vizel — Kazan State Medical University of the Ministry of Health of the Russian Federation; 49 Butlerov Str., Kazan, Russian Federation 420012. Central Scientific and Research Institute of Tuberculosis; 2 Yauzskaya Alley, Moscow, Russian Federation 107564. E-mail: tatpulmo@mail.ru

Доктор.ру

Fig. 1. Prevalence of newly diagnosed interstitial lung diseases by disease entities

r10_1.jpg

Fig. 2. Prevalence of verification methods in patients with verified sarcoidosis (n = 47)

r10_2.jpg

Table 1
Clinical characteristics of patients with newly diagnosed interstitial lung diseases

t10_1.jpg

* Löfgren syndrome.
** Out of 21 examined subjects (2 subjects had Reynaud’s syndrome).

Table 2
Laboratory and spirometric characteristics of patients with newly diagnosed interstitial lung diseases

t10_2.jpg

Table 3
Respiratory function characteristics of patients with newly diagnosed interstitial lung diseases

t10_3.jpg

Table 4
Therapy efficiency in patients with newly diagnosed interstitial lung diseases

t10_4.jpg

Received: 25.04.2020
Accepted: 26.06.2020

22 July 19:26
LITERATURE
  1. Chuchalin A.G., ed. Respiratory medicine: manual. M.: Litterra; 2017. V. 3. 464 p. (in Russian)
  2. Chuchalin A.G., Avdeev S.N., Aisanov Z.R., Belevskiy A.S., Demura S.A., Il’kovich M.M. et al. Diagnosis and treatment of idiopathic pulmonary fibrosis. Federal Guidelines. Pulmonology. 2016; 26(4): 399–421. (in Russian). DOI: 10.18093/0869-0189-2016-26-4-399-419
  3. Olson A.L., Gifford A.H., Inase N., Fernández Pérez E.R., Suda T. The epidemiology of idiopathic pulmonary fibrosis and interstitial lung diseases at risk of a progressive-fibrosing phenotype. Eur. Respir. Rev. 2018; 27(150): pii: 180077. DOI: 10.1183/16000617.0077-2018
  4. Travis W.D., Costabel U., Hansell D.M., King T.E. Jr, Lynch D.A., Nicholson A.G. et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am. J. Respir. Crit. Care Med. 2013; 188(6): 733–48. DOI: 10.1164/rccm.201308-1483ST
  5. Petrov D.V., Ovsyannikov N.V., Kapralov E.A., Kapustyan O.V. Interstitial lung diseases: practitioner’s point of view. Practical Pulmonology. 2014; 1: 34–8. (in Russian)
  6. Bolotova E.V., Shulzhenko L.V., Porkhanov V.A. Faulty pre-hospital diagnostics of interstitial lung diseases. Pulmonology. 2015; 25(1): 41–4. (in Russian)
  7. Nashatyreva M.S., Trofimenko I.N., Chernyak B.A. Structure and clinical characteristics of interstitial lung diseases in the region (Irkutsk). Pulmonology. 2017; 27(6): 740–7. (in Russian)
  8. Vizel A.A., Vizel I.Yu., Amirov N.B. Sarcoidosis epidemiology in the Russian Federation. Journal of Modern Clinical Medicine. 2017; 10(5): 66–73. (in Russian)
  9. Vizel A.A., Bulashova O.V., Amirov N.B., Dmitriev E.G., Kazakov I.M., Islamova L.V. et al. Integral diagnosis and monitoring model for sarcoidosis patients in the current settings. Pulmonology. 2003; 3: 74–9. (in Russian)
  10. Shmelev E.I. Differential diagnostics of interstitial lung diseases. Consilium Medicum. 2003; 5(4): 176–81. (in Russian)
  11. Ilkovich M.M., ed. Interstitial and orphan lung diseases. M.: GEOTAR-Media; 2016. 560 p. (in Russian)
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