Medicolegal Aspect of Alcohol

Acute exacerbations are sudden, severe worsening of respiratory symptoms, including dyspnea and cough, accompanied by rapid decline in lung function. Acute exacerbations are associated with high morbidity and mortality rates and may require hospitalization and intensive care management. Increased pulmonary vascular resistance leading to elevated pulmonary artery pressures and right heart strain. Pulmonary hypertension is a common complication of IPF and is associated with worse prognosis and reduced survival. Increased susceptibility to respiratory infections, including bacterial pneumonia, viral respiratory tract infections, and fungal infections, due to impaired lung function and compromised immune response may develop.
Gastroesophageal Reflux Disease (GERD) is a common comorbidity in idiopathic pulmonary fibrosis patients, with reflux of gastric contents into the esophagus potentially exacerbating pulmonary fibrosis through microaspiration and inflammation.
Increased risk of venous thromboembolism, including pulmonary embolism, in idiopathic pulmonary fibrosis patients may emerge due to impaired lung perfusion, immobility, and hypercoagulability. Reduced bone mineral density and increased risk of fractures due to chronic corticosteroid use, physical inactivity, and systemic inflammation. High prevalence of depression, anxiety, and psychological distress in idiopathic pulmonary fibrosis patients, attributed to chronic illness, physical limitations, functional decline, and uncertainty about prognosis.
Acute exacerbations are a significant predictor of poor prognosis, with increased risk of disease progression and mortality. Advanced age is a negative prognostic factor in idiopathic pulmonary fibrosis, with older patients generally experiencing more rapid disease progression and shorter survival compared to younger individuals. Presence of comorbid conditions, such as cardiovascular disease, diabetes mellitus, and chronic kidney disease, is associated with increased mortality risk in idiopathic pulmonary fibrosis patients. Various prognostic scoring systems, such as the GAP index (gender, age, physiology) and the ILD-GAP index (interstitial lung disease-GAP index), integrate clinical, radiological, and physiological parameters to stratify idiopathic pulmonary patients into risk categories and predict survival outcomes.