Abstract
(1) Background: To assess sex differences in the incidence, characteristics, procedures and outcomes of patients admitted with idiopathic pulmonary fibrosis (IPF); and to analyze variables associated with in-hospital mortality (IHM). (2) Methods: We analyzed data collected by the Spanish National Hospital Discharge Database, 2016–2019. (3) Results: We identified 13,278 hospital discharges (66.4% men) of IPF (primary diagnosis 32.33%; secondary diagnosis: 67.67%). Regardless of the diagnosis position, IPF incidence was higher among men than women, increasing with age. Men had 2.74 times higher IPF incidence than women. Comorbidity was higher for men in either primary or secondary diagnosis. After matching, men had higher prevalence of pulmonary embolism and pneumonia, and women of congestive heart failure, dementia, rheumatoid disease and pulmonary hypertension. Invasive ventilation, bronchoscopy and lung transplantation were received more often by men than women. IHM was higher among men with IPF as primary diagnosis than among women and increased with age in both sexes and among those who suffered cancer, pneumonia or required mechanical ventilation. (4) Conclusions: Incidence of IPF was higher among men than women, as well as comorbidity and use of bronchoscopy, ventilation and lung transplantation. IHM was worse among men than women with IPF as primary diagnosis, increasing with age, cancer, pneumonia or mechanical ventilation use.
Highlights
Idiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial pneumonia of unknown cause, which usually affects elderly adults and is characterized by a radiological or pathological pattern of usual interstitial pneumonia [1]
The objectives of the study were the following: (1) to assess sex-differences in the incidence, clinical characteristics, diagnostic and therapeutic procedures and in-hospital outcomes of patients admitted with a diagnosis, in primary or secondary position, of idiopathic pulmonary fibrosis (IPF) in Spain from 2016 to 2019; (2) to analyze the variables associated with in-hospital mortality (IHM) for men and women hospitalized with IPF as primary diagnosis
We identified 13,278 hospital discharges (66.4% men and 33.56% women) of patients aged ≥18 years admitted with a primary diagnosis of IPF (4294; 32.33%) or secondary diagnosis of IPF (8984; 67.67%) in Spain between 2016 and 2019
Summary
Idiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial pneumonia of unknown cause, which usually affects elderly adults and is characterized by a radiological or pathological pattern of usual interstitial pneumonia [1]. The diagnosis is made, after excluding other causes of interstitial lung disease, with the combination of the radiological and pathological pattern, in those patients who have undergone a surgical biopsy, and the subsequent discussion by a multidisciplinary team [2,3]. In Spain, it is estimated that the incidence is 13 per 100,000 inhabitants in women and 20 per 100,000 inhabitants in men, with an approximate prevalence of 8000–12,000 patients [6,7,8,9]. Variable mortality figures have been described in different countries. In the European WHO registry, in which patients with IPF from 17 countries were collected between the years 2001 to 2013, a mortality of 3.75 per 100,000 in men and 1.50 per 100,000 in women was estimated. This study found variations in the mortality figures over time, so that they tended to decrease in countries such as Austria or Croatia, while in others such as the United Kingdom, Finland or Portugal, an increasing trend in mortality has been reported in recent years [10]
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