In-Hospital Mortality in Patients with Idiopathic Pulmonary Fibrosis: A US Cohort Study.

Abstract

PURPOSE:

In patients with idiopathic pulmonary fibrosis (IPF), hospitalizations are associated with high mortality. We sought to determine in-hospital mortality rates and factors associated with in-hospital mortality in patients with IPF.

METHODS:

Patients with IPF were identified from the Premier Healthcare Database, a representative administrative dataset that includes > 20% of hospital discharges in the US, using an algorithm based on diagnostic codes and billing data. We used logistic regression to analyze associations between patient-, hospital-, and treatment-related characteristics and a composite primary outcome of death during the index visit, lung transplant during the index visit and > 1 day after admission, or death during a readmission within 90 days.

RESULTS:

The cohort comprised 6665 patients with IPF hospitalized between October 2011 and October 2014. A total of 963 (14.4%) met the primary outcome. Factors significantly associated with a higher risk of the primary outcome included mechanical ventilation [odds ratio 4.65 (95% CI 3.73, 5.80)], admission to the intensive care unit [1.83 (1.52, 2.21)], treatment with opioids (3.06 [2.57, 3.65]), and a diagnosis of pneumonia [1.44 (1.21, 1.71)]. Factors significantly associated with a lower risk included concurrent chronic obstructive pulmonary disease [0.65 (0.55, 0.77)] and female sex [0.67 (0.57, 0.79)].

CONCLUSIONS:

Patients with IPF, particularly those receiving mechanical ventilation or intensive care, are at substantial risk of death or lung transplant during hospitalization or death during a readmission within 90 days.

• Authors: Michael T Durheim, Jennifer Judy, Shaun Bender, Dorothy Baumer, Joseph Lucas, Scott B Robinson, Omar Mohamedaly, Bimal R Shah, Thomas Leonard, Craig S Conoscenti, Scott M Palmer
• Journal: Lung (Lung) Vol. 197 Issue 6 Pg. 699-707 (12 2019) ISSN: 1432-1750 [Electronic] United States
• PMID: 31541276 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Opioid

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Analgesics, Opioid (therapeutic use)
• Cohort Studies
• Comorbidity
• Female
• Hospital Mortality
• Humans
• Idiopathic Pulmonary Fibrosis (epidemiology, mortality, therapy)
• Intensive Care Units
• Logistic Models
• Lung Transplantation (statistics & numerical data)
• Male
• Middle Aged
• Patient Readmission (statistics & numerical data)
• Pneumonia (epidemiology)
• Protective Factors
• Pulmonary Disease, Chronic Obstructive (epidemiology)
• Respiration, Artificial
• Risk Factors
• Sex Factors
• United States (epidemiology)