European patients with idiopathic pulmonary fibrosis (IPF) have lengthy and costly hospital stays, mainly because of acute respiratory events, according to a new study.
There is a lack of information about the frequency of acute events among IPF patients, as well as on the outcomes, causes of poor prognosis, and financial burden of the disease. About 4 in every 100,000 people in Europe are believed to have IPF.
For the study, “Burden Of Idiopathic Pulmonary Fibrosis Progression: A 5-Year Longitudinal Follow-Up Study,” researchers analyzed the discharged data of 6,476 IPF patients treated in a French hospital in 2008 (mean age of 77). The patients were followed for five years.
The study was published in the journal PLoS One.
A review of the data showed a median of two hospital stays per patient, with a median stay of eight days. Several reasons were cited for long hospitalizations, including scheduled exams, respiratory conditions (such as respiratory failure, chronic obstructive pulmonary disease, or COPD, and emphysema), or other diseases (such as cancer or coronary artery disease).
Researchers found that 30% of the patients were admitted through the emergency department, and 12% died during their first stay. Most (5,635) were admitted to the hospital at least once because of one or more acute events. In that group:
- 36.5% had an acute respiratory worsening (mortality during hospitalization was 17%, and the median cost was 3,224 euros, or about $3,444)
- 43.7% had a respiratory infection (mortality was 29.5%, and the median cost was 5,432 euros, or about $5,803)
- 51.7% were hospitalized because of a heart event (mortality was 35.7%, and the median cost was 4,584 euros, or nearly §4,900)
About 30% of the events occurred during the first hospitalization.
In-hospital mortality increased from 12.8% during the first stay to 25.9% after a year of follow-up. It reached 36.8% at three years, and 43% at five.
“Progression of IPF leads to hospitalizations, largely related to acute events, and is associated with a poor prognosis and high associated costs,” the researchers wrote. “Our study shows the substantial burden of pulmonary fibrosis, mostly idiopathic, in hospital settings, especially when patients experience acute respiratory events. The new data this study provides can be used to drive health-economic evaluation in order to help develop more accurate pharmacologic strategy guidelines.”