To evaluate hospital mortality and associated risk factors for acute exacerbations of idiopathic pulmonary fibrosis (AEIPF). Emphases were put on incidence and impact of extra-pulmonary organ failures. Patients diagnosed with AEIPF from July 2014 to September 2018 were enrolled. Clinical data were collected. Acute physiology and chronic health evaluation II (APACHE II) and simplified acute physiological score II (SAPS II) were calculated. Extra-pulmonary organ failures were diagnosed upon criteria of sequential organ failure assessment (SOFA). Forty-five patients with AEIPF were included. Eighteen patients (40.0%) developed extra-pulmonary organ failures, and 25 patients (55.6%) died during hospitalization. Serum C-reactive protein (CRP) (p = 0.001), SAPS II (p = 0.004), SOFA (p = 0.001) were higher, whereas arterial oxygen pressure (PaO₂)/ fractional inspired oxygen (FiO₂) (p = 0.001) was lower in non-survivors than survivors. More non-survivors developed extra-pulmonary organ failures than survivors (p = 0.002). After adjustment, elevated serum CRP (OR 1.038, p = 0.049) and extra-pulmonary organ failure (OR 13.126, p = 0.016) were independent predictors of hospital mortality in AEIPF. AEIPF had high hospital mortality and occurrence of extra-pulmonary organ failure was common. Elevated serum CRP and extra-pulmonary organ failure had predictive values for mortality.

评估医院死亡率和特发性肺纤维化（AEIPF）急性加重的相关危险因素。重点放在肺外器官衰竭的发生率和影响上。纳入2014年7月至2018年9月诊断为AEIPF的患者。收集临床数据。计算急性生理和慢性健康评估II（APACHE II）和简化的急性生理评分II（SAPS II）。根据序贯器官衰竭评估（SOFA）的标准诊断肺外器官衰竭。包括四十五例AEIPF患者。住院期间有18例患者（40.0％）发生了肺外器官衰竭，有25例患者（55.6％）死亡。血清C反应蛋白（CRP）（p  = 0.001），SAPS II（p  = 0.004），SOFA（p  = 0.001）较高，而非 存活者的动脉血氧压（PaO ₂）/吸入氧分率（FiO ₂）（p = 0.001）较低。非幸存者发生肺外器官衰竭的比例高于幸存者（p  = 0.002）。调整后，血清CRP升高（OR 1.038，p  = 0.049）和肺外器官衰竭（OR 13.126，p  = 0.016）是AEIPF住院死亡率的独立预测因子。AEIPF的医院死亡率很高，并且肺外器官衰竭的发生率很高。血清CRP升高和肺外器官衰竭对死亡率具有预测价值。