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      Retrospective observational study of trends in hospital admissions for idiopathic pulmonary fibrosis in Spain (2004–2013) using administrative data

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          Abstract

          Objective

          To assess changes in incidence, diagnostic procedures, comorbidity profiles, length of hospital stay (LOHS), economic costs and in-hospital mortality (IHM) associated with idiopathic pulmonary fibrosis (IPF).

          Methods

          We identified patients hospitalised with IPF in Spain from 2004 to 2013. Data were collected from the National Hospital Discharge Database.

          Results

          The study population comprised 22 214 patients. Overall crude incidence increased from 3.82 to 6.98 admissions per 100 000 inhabitants from 2004 to 2013 (p<0.05). The percentage of lung biopsies decreased significantly from 10.68% in 2004 to 9.04% in 2013 (p<0.05). The percentage of patients with a Charlson comorbidity index ≥2 was 15.14% in 2004, increasing to 26.95% in 2013 (p<0.05). IHM decreased from 14.77% in 2004 to 13.72% in 2013 (adjusted OR 0.98; 95% CI 0.97 to 0.99). Mean LOHS was 11.87±11.18 days in 2004, decreasing to 10.20±11.12 days in 2013 (p<0.05). The mean cost per patient increased from €4838.51 in 2004 to €5410.90 in 2013 (p<0.05).

          Conclusions

          The frequency of hospital admissions for IPF increased during the study period, as did healthcare costs. However, IHM and LOHS decreased.

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          Most cited references22

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          Permutation tests for joinpoint regression with applications to cancer rates.

          H. Kim, M P Fay, E. J. Feuer … (2000)
          The identification of changes in the recent trend is an important issue in the analysis of cancer mortality and incidence data. We apply a joinpoint regression model to describe such continuous changes and use the grid-search method to fit the regression function with unknown joinpoints assuming constant variance and uncorrelated errors. We find the number of significant joinpoints by performing several permutation tests, each of which has a correct significance level asymptotically. Each p-value is found using Monte Carlo methods, and the overall asymptotic significance level is maintained through a Bonferroni correction. These tests are extended to the situation with non-constant variance to handle rates with Poisson variation and possibly autocorrelated errors. The performance of these tests are studied via simulations and the tests are applied to U.S. prostate cancer incidence and mortality rates. Copyright 2000 John Wiley & Sons, Ltd.
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            Mortality from pulmonary fibrosis increased in the United States from 1992 to 2003.

            David K Brown, Mikel Olson, Jeffrey Swigris … (2007)
            From the late 1970s to the early 1990s, studies found that mortality rates for pulmonary fibrosis were increasing. Recent data for mortality from pulmonary fibrosis are unavailable. We sought to determine mortality rates for pulmonary fibrosis in the United States from 1992 through 2003. Using data from the National Center for Health Statistics, we calculated age-adjusted mortality rates from the deaths of persons with pulmonary fibrosis and stratified the data to determine differences in mortality rates by age, sex, race/ethnicity, and geography of the decedent. We developed a multivariable model to predict future mortality rates, and we determined the underlying cause of death in patients with pulmonary fibrosis. From 1992 to 2003, there were 28,176,224 deaths in the United States and 175,088 decedents with pulmonary fibrosis. The average age- and sex-adjusted mortality rate was 50.8 per 1,000,000 people. The age-adjusted mortality rate increased 28.4% in men (from 40.2 deaths per 1,000,000 in 1992 to 61.9 deaths per 1,000,000 in 2003) and 41.3% in women (from 39.0 deaths per 1,000,000 in 1992 to 55.1 deaths per 1,000,000 in 2003). While increases were significant in both men and women (p < 0.0001), the rate of increase was higher in women (p < 0.0001). The most common cause of death in patients with pulmonary fibrosis was the disease itself. From 1992 to 2003, mortality rates for pulmonary fibrosis significantly increased. Further investigation is needed to determine the etiology of these trends, which are predicted to continue to increase.
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              Epidemiology of interstitial lung diseases in Greece.

              A Karakatsani, D. Papakosta, A Rapti … (2009)
              Few data are available on the epidemiology of interstitial lung diseases (ILDs), especially after the current classification of idiopathic interstitial pneumonias. The aim of this study is to provide data on the epidemiology of ILDs in Greece, under the ATS/ERS international consensus. Departments of Pneumonology were contacted and asked to complete a questionnaire for every case of ILD that was alive on 2004 as well as for every new case from 1st January 2004 to 31st December 2004. Questions on the patients' demographic data, the exact diagnosis and the procedures used to establish the diagnosis were included. Centers covering about 60% of the Greek population have been analyzed. A total of 967 cases have been registered. The estimated prevalence of ILDs is 17.3 cases per 100,000 inhabitants. The estimated annual incidence of ILDs is 4.63 new cases per 100,000 inhabitants. The most frequent disease is sarcoidosis (34.1%), followed in decreasing order by idiopathic pulmonary fibrosis (19.5%), ILD associated with collagen vascular diseases (12.4%), cryptogenic organizing pneumonia (5.3%), histiocytosis (3.8%), and hypersensitivity pneumonitis (2.6%). Unclassified ILD or not otherwise specified accounted for the 8.5% of prevalent cases. These data suggest that sarcoidosis and idiopathic pulmonary fibrosis are the most frequent ILDs in our population. In comparison with the few previous reports, interesting dissimilarities have been observed.
              Article 0 comments Cited 65 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2017
                Publication date (Electronic): 13 February 2017
                Volume: 7
                Issue: 2
                Electronic Location Identifier: e013156
                Affiliations
                [1 ]Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM) , Madrid, Spain
                [2 ]Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos , Alcorcón, Madrid, Spain
                [3 ]Universidad Rey Juan Carlos , Alcorcón, Madrid, Spain
                Author notes
                [Correspondence to ] Dr Javier de Miguel Díez; javier.miguel@ 123456salud.madrid.org
                Article
                Publisher ID: bmjopen-2016-013156
                DOI: 10.1136/bmjopen-2016-013156
                PMC ID: 5318548
                PubMed ID: 28193850
                SO-VID: c303e6b1-987e-48cb-a02c-d5c86da4ae61
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 25 June 2016
                Date revision received : 12 December 2016
                Date accepted : 14 December 2016
                Categories
                Subject: Respiratory Medicine
                Subject: Research
                Subject: 1506
                Subject: 1731
                Subject: 1692

                ScienceOpen disciplines: Medicine
                Keywords: idiopathic pulmonary fibrosis,hospitalization,length of hospital stay,cost,in-hospital mortality
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: idiopathic pulmonary fibrosis, hospitalization, length of hospital stay, cost, in-hospital mortality

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