Is There an Age Limit to Lung Transplantation?

Roy, Sreeja Biswas; Alarcón, Diana; Walia, Rajat; Chapple, Kristina; Bremner, Ross M.; Smith, Michael A.

doi:10.1016/j.athoracsur.2015.02.092

Cited by 40 publications

(26 citation statements)

References 23 publications

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“…Raimundo et al [32] also used insurance claims data to examine the impact of IPF on HCRU, separately in 2009, 2010 and 2011.The range of mean age of the cohorts was 69.8-71.3 and approximately 50% of each cohort was male. In comparison, our study population had higher proportion of patients hospitalized in the past year (51% vs. 37%), lower number of outpatient visits (14.8 vs. 18.5), lower use of oral corticosteroids (33.4% vs. 44.6%).…”

Section: Discussionmentioning

confidence: 99%

Characterizing idiopathic pulmonary fibrosis patients using US Medicare-advantage health plan claims data

et al. 2019

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BackgroundIdiopathic pulmonary fibrosis (IPF) is a rare life-threating interstitial lung disease (ILD). This study characterizes demographics, health care utilization, and comorbidities among elderly IPF patients and estimates prevalence and incidence rates for selected outcomes.MethodsCohort study using a large US health insurance database (Optum’s Medicare Advantage plan). Inclusion criteria: ≥ 1 diagnosis code for IPF (2008 - 2014), age ≥65 years, no diagnosis of IPF or other ILD in prior 12 months. Demographics, health care utilization, comorbidities and incidence rates for various outcomes were estimated. Follow-up continued until the earliest of: health plan disenrollment, death, a claim for another known cause of ILD, or end of the study period.Results4,716 patients were eligible; 53.4% had IPF diagnostic testing. Median age was 77.5 years, 50.3% were male, median follow-up time was 0.8 years. Incidence rates ranged from 1.0/1,000 person-years (lung transplantation) to 374.3/1,000 person-years (arterial hypertension). Baseline characteristics and incidence rates were similar for cohorts of patients with and without IPF diagnostic testing.ConclusionsElderly IPF patients experience a variety of comorbidities before and after IPF diagnosis. Therapies for IPF and for the associated comorbidities may reduce morbidity and associated health care utilization of these patients.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0759-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Characterizing idiopathic pulmonary fibrosis patients using US Medicare-advantage health plan claims data

et al. 2019

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“…Lung transplantation is generally limited to patients under 65 years of age, although in very select groups it has been performed in the seventh decade. 52 …”

Section: Treatmentmentioning

confidence: 99%

Non-cystic fibrosis bronchiectasis in the elderly: current perspectives

Quinn

Hill

2018

CIA

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Bronchiectasis is a chronic lung disease with permanently damaged airways predisposing to recurrent respiratory tract infections. There is an increasing prevalence of bronchiectasis in the elderly, affecting approximately 10 patients per 1,000 population. Studies have shown that older, frailer patients tend to have a more severe and symptomatic disease, with those aged 80 and above with worse quality of life, increased hospitalization and increased mortality. These patients will be encountered by clinicians working in all aspects of elderly care. This review covers the various investigations and aspects of treatment for bronchiectasis and how they may be utilized in a more older and generally frailer population.

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“…Similar to our findings, the 2016 International Society for Heart and Lung Transplantation (ISHLT) registry reported that the risk of 1-year posttransplant mortality rose at age 55 1 and multiple studies demonstrated that older recipients, > 60 years 4 , > 70 years 8 , and > 75 years 9 of age had worse survival than younger recipients. In contrast, other studies showed that recipients, > 60 6,7 , > 65 5,7 , and > 70 years of age 10,23 can experience equivalent survival to those who are younger.…”

Section: Survival and Age In Contextmentioning

confidence: 83%

“…Multiple U.S. and international studies have demonstrated increased posttransplant mortality among older lung transplant recipients [3][4][5] while others have not found a difference in mortality 6,7 . Generalizability of prior analyses is limited by center-specific practice variations, variable age classifications, and measurements spanning changes in lung allocation systems particularly in the U.S. which accounts for > 50% of all lung transplants performed worldwide.…”

Section: Introductionmentioning

confidence: 99%

Extremes of Age Decrease Survival After Lung Transplant

Lehr

McCurry

et al. 2018

The Journal of Heart and Lung Transplantation

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CARLI J. LEHR The aim of this study was to determine impact of the age of lung transplant recipients on survival after lung transplant. We used data from the Scientific Registry of Transplant Recipients and studied 14,253 adult lung transplant recipients between January 1, 2006 and February 19, 2015. Survival was estimated using a non-proportional hazard model and random-survival forest methodology to examine risk-factors for death. Risk factors were obtained for the entire population and additional age-specific risk factors were identified for each age category. There were 1,098 (7.7%) recipients < 30 years, 4,201 (29.5%) 30-55 years, and 8,954 (62.8%) > 55 years of age. The youngest and oldest recipients experienced the lowest post-transplant survival. Risk factors for death for the entire population included extremes of age, higher creatinine, single lung transplant, hospitalization prior to transplant, and increased bilirubin. Age was the most significant risk factor for death at all time-points following transplant.

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Is There an Age Limit to Lung Transplantation?

Cited by 40 publications

References 23 publications

Characterizing idiopathic pulmonary fibrosis patients using US Medicare-advantage health plan claims data

Characterizing idiopathic pulmonary fibrosis patients using US Medicare-advantage health plan claims data

Non-cystic fibrosis bronchiectasis in the elderly: current perspectives

Extremes of Age Decrease Survival After Lung Transplant

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