Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Department of Pulmonary Immunotherapeutics, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Respir Investig. 2023 Mar;61(2):172-180. doi: 10.1016/j.resinv.2022.12.003. Epub 2023 Jan 23.
Three epidemiological small-scale studies on hypersensitivity pneumonitis (HP) have been performed in Japan to date. Herein, we aimed to clarify the clinical characteristics of various types of HP diseases using a large nationwide database in Japan.
We used the Japanese Diagnostic Procedure Combination database that includes data from 1,031 participant hospitals. Patients with HP from 2011 to 2017 were identified using International Classification of Diseases 10th Revision codes. We analyzed patient characteristics, the yearly transition of the number of HP cases, rate per one million hospitalizations, geographical distribution, seasonality, and risk factors for in-hospital mortality.
In total, 3,634 patients with HP were identified, including summer-type HP (SHP) (n = 490), bird fancier's lung (BFL) (n = 199), ventilation pneumonitis (n = 106), farmer's lung (n = 48), and unspecified HP (n = 2761). The length of hospital stay was significantly longer in patients with BFL (19 days) than in patients with SHP (15 days). SHP was more prevalent in the southwestern region of Japan, and hospitalization occurred mainly in summer (37.8%) and fall (37.3%). Ventilation pneumonitis was predominant in winter (28.6%) and spring (38.7%). In-hospital mortality was significantly associated with old age (p < 0.001), low body mass index (p = 0.016), severe dyspnea (p < 0.001), and BFL diagnosis on admission (p = 0.031).
This study revealed the clinical characteristics of SHP and BFL, including the frequency of causative antigens, geographical distribution, seasonality, and risk factors for mortality, which may help in diagnosing HP and identifying causative antigens.
迄今为止，日本已经进行了三项关于过敏性肺炎（HP）的小型流行病学研究。在此，我们旨在使用日本的一个大型全国性数据库来阐明各种类型 HP 疾病的临床特征。
我们使用了包含来自 1031 家参与医院的数据的日本诊断程序组合数据库。使用国际疾病分类第 10 次修订版代码从 2011 年至 2017 年确定 HP 患者。我们分析了患者特征、HP 病例数量的逐年变化、每百万住院患者的发病率、地理分布、季节性和住院死亡率的危险因素。
共确定了 3634 例 HP 患者，包括夏型 HP（SHP）（n=490）、饲鸟者肺（BFL）（n=199）、通风性肺炎（n=106）、农民肺（n=48）和未特指的 HP（n=2761）。BFL 患者的住院时间明显长于 SHP 患者（19 天）。SHP 在日本西南部更为普遍，住院主要发生在夏季（37.8%）和秋季（37.3%）。通气性肺炎在冬季（28.6%）和春季（38.7%）更为普遍。住院死亡率与年龄较大（p<0.001）、低体重指数（p=0.016）、严重呼吸困难（p<0.001）和入院时的 BFL 诊断（p=0.031）显著相关。
本研究揭示了 SHP 和 BFL 的临床特征，包括致病抗原的频率、地理分布、季节性和死亡率的危险因素，这可能有助于诊断 HP 和确定致病抗原。
