The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: A nationwide retrospective cohort analysis

Abstract

ObjectiveTo investigate the mortality of patients with Idiopathic Pulmonary Fibrosis (IPF) who undergo mechanical ventilation (MV) and non-invasive mechanical ventilation (NIMV) in the United States. MethodsWe performed a retrospective cohort study using data from the Nationwide Inpatient Sample, isolating patients with a diagnosis of IPF who underwent MV and NIMV between 2006 and 2012. ResultsWe analyzed 55,208,382 hospitalizations and identified 17,770 patients with IPF, of whom 1703 received MV and 778 received NIMV. Those receiving MV had higher mortality (51.6 vs 30.9%, p < 0.0001), were younger (66.3 years, SD 12.8 vs 70.2 years, SD 12.9) and had longer hospital stays (13.3 days, IQR 16 vs 6.5 days, IQR 7, p < 0.0001), compared to those receiving NIMV.The mortality of IPF patients treated with MV decreased from 58.4% in 2006 to 49.3% in 2012 (p = 0.03). There were 149 (8.7%) patients in the mechanical ventilation group who were also receiving home oxygen therapy. They experienced an overall mortality of 48.1%, which was not significantly different than patients who did not rely on home oxygen (p = 0.35). ConclusionsIn a large national cohort, the in-hospital mortality of patients with IPF who are mechanically ventilated is approximately 50%.