Clinical Significance of Age and Coexisting Lifestyle-related Diseases in ILD Patients with Acute Exacerbation

OBJECTIVE: As the population ages, the impact of aging and comorbid lifestyle-related diseases on the prognosis of interstitial lung disease (ILD) has not been fully investigated. Therefore, we investigated the impact of age and comorbidities on the prognosis of patients with ILD who experienced acute exacerbations (AEs). MATERIAL AND METHODS: We retrospectively reviewed the medical records and chest computed tomography scans of all consecutive ILD patients, with or without AE, between May 2015 and July 2025. The survival times of cases with and without AE were investigated. RESULTS: Median survival time (MST) for 443 ILD cases was 10 years, while the MST for the 158 cases who developed AE was 2 months. The prognosis of cases who developed AE at age 80 years or older was significantly poorer than that of cases younger than 80 years. Among cases younger than 80 years, the survival curve for those who survived 3 months after the onset of AE plateaued. Favorable factors among cases who developed AE were age younger than 80 years and absence of comorbidities such as hypertension, diabetes mellitus, and malignancy. CONCLUSION: For ILD patients who developed AE, "80 years of age" was the threshold age distinguishing good from poor prognosis. Some patients, particularly those with ILD who were diagnosed early, appeared likely to have an improved prognosis. Some AE patients, particularly younger patients, could be expected to have a good long-term prognosis if they survive a certain period of time.