Co‐morbidity and mortality among patients with interstitial lung diseases: A population‐based study

Hilberg, Ole; Bendstrup, Elisabeth; Løkke, Anders; Ibsen, Rikke; Fløe, Andreas; Hyldgaard, Charlotte

doi:10.1111/resp.13234

Cited by 18 publications

(15 citation statements)

References 41 publications

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“…These results are comparable to what has been observed in cohorts of other registry- based studies and publications [6, 15–18]. Previous studies have also shown that cardiovascular diseases are more frequent in patients with IPF [18] as well as other ILDs [19] compared to matched controls.…”

Section: Discussionsupporting

confidence: 89%

“…While analyses on survival on the Australian cohort showed no effect on outcome, the cohort in Germany, where almost 90% of patients had one or more comorbidity, showed that the number of comorbidities were associated with mortality. A recent Danish study [19] on comorbidities and mortality in patients with ILDs, showed a significant difference in the frequency of comorbidities and mortality compared to age and gender matched non- ILD controls.…”

Section: Discussionmentioning

confidence: 99%

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Gender differences at presentation of idiopathic pulmonary fibrosis in Sweden

et al. 2019

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BackgroundIdiopathic pulmonary fibrosis (IPF) is a disease with poor prognosis mainly affecting males. Differences in clinical presentation between genders may be important both for the diagnostic work-up and for follow-up. In the present study, we therefore explored potential gender differences at presentation in a Swedish cohort of IPF-patients.MethodsWe studied patients included in the Swedish IPF- registry over a three-year period from its launch in 2014. A cross-sectional analysis was performed for data concerning demographics, lung function, 6- min walking test (6MWT) and quality of life (QoL) (King’s Brief Interstitial Lung Disease (K-BILD) score).ResultsThree hundred forty- eight patients (250 (72%) males, 98 (28%) females, median age 72 years in both genders) were included in the registry during the study period. Smoking history (N = 169 (68%) vs. N = 53 (54%), p < 0.05), baseline lung function (Forced vital capacity, % of predicted (FVC%): 68.9% ± 14.4 vs. 73.0% ± 17.7, p < 0.05; Total lung capacity, % of predicted (TLC%): 62.2% ± 11.8 vs. 68.6% ± 11.3%, p < 0.001) were significantly different at presentation between males and females, respectively. Comorbidities such as coronary artery disease (OR: 3.5–95% CI: 1.6–7.6) and other cardiovascular diseases (including atrial fibrillation and heart failure) (OR: 3.8–95% CI: 1.9–7.8) also showed significant differences between the genders. The K- BILD showed poor quality of life, but no difference was found between genders in total score (54 ± 11 vs. 54 ± 10, p = 0.61 in males vs. females, respectively).ConclusionsThis study shows that female patients with IPF have a more preserved lung function than males at inclusion, while males have a significant burden of cardiovascular comorbidities. However, QoL and results on the 6MWT did not differ between the groups. These gender differences may be of importance both at diagnosis and follow- up of patients with IPF.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Gender differences at presentation of idiopathic pulmonary fibrosis in Sweden

et al. 2019

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“…With updated IPF guidelines, it also became evident that referral to tertiary ILD centers with access to multidisciplinary discussions improved the diagnostic confidence concurrent with a reduced diagnostic latency and mortality [6,32,33]. By use of this guideline recommended multidisciplinary discussion approach from 2011 and onwards, we expect that the ICD10-codes registered during the observation period 2011-2017 actually represent true IPF diagnoses [34]. Finally, though the number of IPF cases are comparable to IPF cohorts in previous register-based IPF studies [9,[12][13][14], the small patient number, however, may limit the statistical precision.…”

Section: Discussionmentioning

confidence: 96%

Dynamics in diagnoses and pharmacotherapy before and after diagnosing idiopathic pulmonary fibrosis

et al. 2020

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BackgroundIdiopathic pulmonary fibrosis (IPF) is a well-characterised interstitial lung disease (ILD). Typically, the IPF diagnosis is delayed due to non-specific symptoms, but can also be delayed due to treatment attempts on false indication, or due to treatment targeting common comorbidities. This observational study aimed to assess the dynamics in the medication and diagnosis patterns in the period before and after an IPF diagnosis.MethodsWe identified all Danish patients with IPF during 2002 to 2017. We evaluated new and ongoing drug treatments and incident diagnoses 36 months before, and 12 months after an IPF diagnosis by use of Danish nationwide registries. To aid interpretation, ten random controls were recruited for each case.ResultsA total of 650 IPF patients were identified (median age 73 years [IQR 65–78], 70.3% males). Prior to the IPF diagnosis, the most prevalent diagnoses were dyspnea and non-IPF ILDs. For drug use, IPF patients had higher initiation rates for antibiotics, oral corticosteroids and mucolytics. In terms of drug volume, IPF patients used more respiratory drugs, antibiotics, immunosuppressants, corticosteroids, proton pump inhibitors, benzodiazepines and opium alkaloids within the 6 months preceding their IPF diagnosis, compared to the controls. Overall drug use decreased after an IPF diagnosis, mainly due to a reduced glucocorticoid and cardiovascular drug use.ConclusionAmong IPF patients, an increased drug use was observed for diagnoses with symptoms overlapping those of IPF, particularly this was observed during the last 6 months before an IPF diagnosis. This emphasises the need for an increased IPF awareness.

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“…A new cluster analysis among adults with various chronic ILD has been conducted, and four distinct clinical phenotypes were identified, allowing a better prediction of clinical outcomes than the current ILD diagnostic criteria. Having been said that genetic and environments are considerable impacting ILD epidemiology and natural history, we must not forget the role of co‐morbidities due to their impact on worsening of patient’s survival as seen in recent works conducted in Denmark and Germany along with the role of histopathological findings on disease progression …”

Section: Interstitial Lung Diseasementioning

confidence: 99%