Abstract Background The prognostic value of glycated haemoglobin (HbA1c) for fibrotic interstitial lung disease (F-ILD) is uncertain. We assessed its association with respiratory failure, mechanical ventilation, and cause-specific mortality. Methods We conducted a retrospective cohort study of F-ILD at West China Hospital from 2014 to 2024. Patients were categorised as HbA1c ≥6.5% or 6.5%. The primary endpoint was cause-specific mortality. Secondary endpoints were respiratory failure and mechanical ventilation after the first 24 h. Univariable analyses and LASSO informed covariate selection. Independent risk factors for mortality were identified with multivariable Cox models, and for respiratory failure and mechanical ventilation with multivariable logistic regression. Results Among 191 patients, 102 (53.4%) were classified as HbA1c≥6.5% and 89 (46.6%) as 6.5%. Over a median follow-up of 34 months (IQR 13-78), 104 patients (54.5%) experienced cause-specific mortality. In multivariable Cox models, HbA1c (adjusted hazard ratio aHR = 1.178, p = 0.012), age (aHR = 1.020, p = 0.037), and BUN (aHR = 1.079, p = 0.047) were independently associated with increased cause-specific mortality (Figure 1A). In multivariable logistic regression, HbA1c and absolute neutrophil count(ANC) independently predicted respiratory failure (adjusted odds ratio aOR 1.299, p = 0.036; 1.235, p 0.001) (Figure 1B) and mechanical ventilation (aOR 1.391, p = 0.017; 1.119, p = 0.026)(Figure 1C). Conclusions HbA1c independently predicted cause-specific mortality, and together with ANC identified patients at increased risk of respiratory failure and mechanical ventilation. Incorporating HbA1c and ANC into admission triage may support early palliative assessment and targeted glycaemic optimisation in hospitalized F-ILD. This abstract is funded by: 无
Sun et al. (Fri,) studied this question.