Comorbidity burden and survival in patients with idiopathic pulmonary fibrosis: the EMPIRE registry study

Zembacher, Stefan; Studnicka, Michael; Lang, David; Lamprecht, Bernd; Stoeva, Natalia; Mladinov, Suzana; Ilak, Dino; Vergles, Mirna; Tudorić, Neven; Tekavec-Trkanjec, Jasna; Vašáková, Martina; Šterclová, Martina; Jiří,; Lacina, Ladislav; Lisá, Pavlína; Bittenglová, Radka; Bartoš, Vladimı́r; [], Renata; Lošťáková, Vladimíra; Žůrková, Monika; Pšíkalová, Jana; Binková, Ilona; Doubková, Martina; Kervitzer, Jan; Snížek, Tomáš; Reiterer, Pavel; Šuldová, Hana; Plačková, Martina; Tyl, Richard; Řihák, Vladimír; Dušek, Ladislav; Hejduk, Karel; Gregor, Jakub; Májek, Ondřej; Littnerová, Simona; Svoboda, Michal; Zsiray, Miklós; Müller, Veronika; Bohács, Anikó; Szilasi, Mária; Szalai, Zsuzsanna; Balikó, Zoltán; Somfay, Attila; Lajkó, Imre; Kramer, Mordechai; Adir, Yochai; Kjaeva, Biserka Jovkovska; Jassem, Ewa; Siemińska, Alicja; Szymanowska-Narloch, Amelia; Barczyk, Adam; Sładek, Krzysztof; Kania, Aleksander; Kasper, Łukasz; Stachura, Tomasz; Jurek, Paulina; Majewski, Sebastian; Nowicka, Agata; Borucki, Łukasz; Lewandowska, Katarzyna; Sobiecka, Małgorzata; Zolnowska, Beate; Śliwiński, Paweł; Korzybski, Damian; Martusewicz-Boros, Magdalena; Wiatr, Elżbieta; Maskey-Warzęchowska, Marta; Górska, Katarzyna; Barnaś, Małgorzata; Vučinić-Mihailović, Violeta; Milenković, Branislava; Kontić, Milica; Samardžić, Natalija; Roksandić, Marina; Jovanović, Dragana; Pejčić, Tatjana; Boravac, Desa Nastasijevic; Videnovic, Emilija; Petković, Tatjana; Djordejevic, Ivanka; Lečić, Svetlana Kašiković; Kuruc, Vesna; Eri, Živka; Panjković, Milana; Lovrenski, Aleksandra; Kukavica, Darinka; Jakić, Ana; Mojsilović, Slavica; Hájková, Marta; Laššán, Štefan; Tóth, Štefan; Plutinský, Ján; Vyšehradský, Róbert; Matula, Bohumil; Slivka, Róbert; Jonner, Imrich; Moğulkoç, Nesrin

doi:10.1186/s12931-022-02033-6

Cited by 10 publications

(2 citation statements)

References 49 publications

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“…Our study addresses a gap in knowledge by identifying comorbidities associated with poor prognosis specifically in hospitalized patients with AE-IPF. The burden of comorbidities is noted to be high among IPF patients, and increasing number of comorbidities has been associated with worse survival [37]. However, to our knowledge, our study is unique in examining the impact of comorbidity on mortality in AE-IPF.…”

Section: Strengths and Limitationsmentioning

confidence: 95%

The Impact of Chronic Comorbidities on Outcomes in Acute Exacerbations of Idiopathic Pulmonary Fibrosis

Baig,

Yoo

2024

Life

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Introduction: Idiopathic pulmonary fibrosis is a chronic progressive lung disease of unknown cause with a high associated mortality. We aimed to compare the impact of chronic medical conditions on hospital outcomes of patients with acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). Methods: This was a retrospective cohort study using the NIS database from 2016 to 2018. We included patients aged 60 and older hospitalized in academic medical centers with the diagnoses of IPF and acute respiratory failure. We examined factors associated with hospital mortality and length of stay (LOS) using survey-weighted multivariate logistic and negative binomial regression. Results: Out of 4975 patients with AE-IPF, 665 (13.4%) did not survive hospitalization. There was no difference in the mean age between survivors and non-survivors. Patients were more likely to be male, predominantly white, and have Medicare coverage. Most non-survivors were from households with higher median income. Hospital LOS was longer among non-survivors than survivors (9.4 days vs. 9.8 days; p < 0.001). After multivariate-logistic regression, diabetes was found to be protective (aOR 0.62, 95% CI 0.50–0.77; p < 0.0001) while chronic kidney disease (CKD) conferred a significantly higher risk of death after AE-IPF (aOR 6.85, 95% CI 1.90–24.7; p = 0.00). Our multivariate adjusted negative binomial regression model for LOS identified obesity (IRR 0.85, 95% CI 0.76–0.94; p ≤ 0.00) and hypothyroidism (IRR 0.90, 95% CI 0.83–0.98; p = 0.02) to be associated with shorter hospital LOS. Conclusions: Our results suggest that CKD is a significant contributor to hospital mortality in AE-IPF, and diabetes mellitus may be protective. Obesity and hypothyroidism are linked with shorter hospital LOS among patients hospitalized with AE-IPF in US academic medical centers.

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Section: Strengths and Limitationsmentioning

confidence: 95%

The Impact of Chronic Comorbidities on Outcomes in Acute Exacerbations of Idiopathic Pulmonary Fibrosis

Baig,

Yoo

2024

Life

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“…IPF is associated with several comorbidities [ 7 , 8 ] such as cardiovascular disease, gastroesophageal reflux, and chronic obstructive pulmonary disease. Multimorbidity often leads to the use of multiple medications [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Overall drug treatment of idiopathic pulmonary fibrosis patients from national registries – a real-world study from Finland

Kaunisto,

Salomaa,

Koivisto

et al. 2023

BMC Pulm Med

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Background Currently, two disease-modifying antifibrotic drugs are indicated for the treatment of idiopathic pulmonary fibrosis. The objective of this study was to analyse antifibrotic and overall prescription medication use of IPF patients in the real world. Methods Data was collected from the FinnishIPF registry and the Registry of the Social Insurance Institution of Finland (SII). Purchases of all prescription medicines were assessed. The frequency, the initiation interval, the duration, and the breaks of the antifibrotic treatments were defined. The association between the prescription of antifibrotic therapy and different patient-related clinical parameters was studied. Accordingly, the relationships between the delay in starting therapy and patient-related variables were analysed. Results Of the 263 IPF patients, 132 (50.2%) had started antifibrotic treatment during the study period 2011–2018. The mean interval from the diagnosis to the first purchase was 367 (SD 429) days. The antifibrotic drug was switched in 14% of patients. Discontinuation of therapy occurred most commonly during the first year of the treatment. The one-year persistence was 77.1% for pirfenidone and 78.9% for nintedanib. A tendency of treating patients under 75 years was noticed. Low forced vital capacity predicted earlier initiation of medication. Conclusions The initiation of antifibrotics after diagnosis was slow, probably due to reimbursement limitations. Younger age at diagnosis affected treatment initiation although it is unknown which patients benefit most from these medications. The reasons for discontinuation of the antifibrotic therapy during the first year should be a focus in clinical work and further studies.

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Risk of obstructive sleep apnea in idiopathic pulmonary fibrosis

Wang¹,

Shen²,

Lin³

et al. 2023

European Journal of Internal Medicine

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Comorbidity burden and survival in patients with idiopathic pulmonary fibrosis: the EMPIRE registry study

Cited by 10 publications

References 49 publications

The Impact of Chronic Comorbidities on Outcomes in Acute Exacerbations of Idiopathic Pulmonary Fibrosis

The Impact of Chronic Comorbidities on Outcomes in Acute Exacerbations of Idiopathic Pulmonary Fibrosis

Overall drug treatment of idiopathic pulmonary fibrosis patients from national registries – a real-world study from Finland

Risk of obstructive sleep apnea in idiopathic pulmonary fibrosis

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