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Hospitalisation patterns of patients with interstitial lung disease in the light of comorbidities and medical treatment - a German claims data analysis.
Respir. Res. 21:73 (2020)
Background Interstitial lung disease (ILD) is a heterogeneous group of mainly chronic lung diseases differing in disease course and prognosis. For most subtypes, evidence on relevance and outcomes of hospitalisations is lacking. Methods Using German claims data we investigated number of hospitalisations (zero-inflated-negative-binomial models providing rate ratios (RR)) and time to first hospitalisation (Cox proportional-hazard models providing hazard ratios (RR)) for nine ILD-subtypes. Models were stratified by ILD-related and non-ILD-related hospitalisations. We adjusted for age, gender, ILD-subtype, ILD-relevant comorbidities and ILD-medication (immunosuppressive drugs, steroids, anti-fibrotic drugs). Results Among 36,816 ILD-patients (mean age 64.7 years, 56.2% male, mean observation period 9.3 quarters), 71.2% had non-ILD-related and 56.6% ILD-related hospitalisations. We observed more and earlier non-ILD-related hospitalisations in ILD patients other than sarcoidosis. Medical ILD-treatment was associated with increased frequency and in case of late initiation, earlier (non-)ILD-related hospitalisations. Comorbidities were associated with generally increased hospitalisation frequency except for COPD (RR = 0.90) and PH (RR = 0.94) in non-ILD-related and for lung cancer in ILD-related hospitalisations (RR = 0.89). Coronary heart disease was linked with earlier (ILD-related: HR = 1.17, non-ILD-related HR = 1.19), but most other conditions with delayed hospitalisations. Conclusion Hospitalisations are frequent across all ILD-subtypes. The hospitalisation risk might be reduced independently of the subtype by improved management of comorbidities and improved pharmacological and non-pharmacological ILD therapy.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Interstitial Lung Disease ; Hospitalisation ; Comorbidity; Idiopathic Pulmonary-fibrosis; Clinical-practice; Exacerbation
ISSN (print) / ISBN
1465-9921
e-ISSN
1465-993X
Journal
Respiratory Research
Quellenangaben
Volume: 21,
Issue: 1,
Article Number: 73
Publisher
BioMed Central
Publishing Place
Campus, 4 Crinan St, London N1 9xw, England
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Reviewing status
Peer reviewed