Burden of Idiopathic Pulmonary Fibrosis Progression: A 5-Year Longitudinal Follow-Up Study.
Burden of Idiopathic Pulmonary Fibrosis Progression: A 5-Year Longitudinal Follow-Up Study.
复制标题
特发性肺纤维化进展的负担：一项 5 年纵向随访研究。
DOI：
10.1371/journal.pone.0166462
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Bénard S
中科院分区：
文献类型：
--
作者：
Cottin V;Schmidt A;Catella L;Porte F;Fernandez-Montoya C;Le Lay K;Bénard S
特发性肺纤维化（IPF）是一种病程不可预测的致死性肺部疾病。使用法国医院出院数据库建立了一项观察性研究，以描述与该疾病相关的住院原因、结果和费用。2008年因特发性肺纤维化（ICD-10代码：J84.1）新住院的患者被确定并随访5年。由于J84.1包括其他纤维化肺部疾病，因此定义了一种排除年龄<50岁且次年存在鉴别诊断的算法。总的来说，确定了6476例患者；其中30%通过急诊科入院，12%在第一次住院时死亡。大多数患者因一种或几种急性事件至少住院一次（n = 5,635；占患者的87.0%），其中36.5%的患者患有急性呼吸系统恶化(住院死亡率为17.0%，中位数费用为3,224欧元；四分位数范围（IQR€889-6,092）)，43.7%的呼吸道感染患者（住院死亡率为29.5%，中位数费用为5,432欧元（IQR, 3,520 - 9,115欧元））和51.7%的心脏事件患者（住院死亡率为35.7%，中位数费用为4,584欧元（IQR, 2,803-6,399欧元））；其中30.2%发生在首次住院期间。最后，住院3年粗死亡率为36.8%。这项研究首次提供了法国肺纤维化患者住院的广泛数据，主要是特发性的，显示了高负担和住院费用。
Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with an unpredictable course. An observational study was set up using the French hospital discharge database to describe the reasons, outcomes and costs of hospitalisations related to this disease. Patients newly hospitalised for idiopathic pulmonary fibrosis (ICD-10 code: J84.1) in 2008 were identified and followed for 5 years. As J84.1 includes other fibrotic pulmonary diseases, an algorithm excluding age<50 years and presence of a differential diagnosis in the following year was defined. Overall, 6,476 patients were identified; of whom 30% were admitted through the emergency unit and 12% died during their first hospitalisation. Most of patients were hospitalised at least once for one or several acute events (n = 5,635; 87.0% of patients), of whom 36.5% of patients with an acute respiratory worsening (in-hospital mortality of 17.0% and median cost of €3,224; interquartile range (IQR €889–6,092)), 43.7% of patients with a respiratory infection (in-hospital mortality of 29.5% and median cost of €5,432 (IQR, €3,620–9,115)) and 51.7% of patients with a cardiac event (in-hospital mortality of 35.7% and median cost of €4,584 (IQR, €2,803–6,399)); 30.2% of these events occurred during the first hospitalisation. Finally, the 3-year in-hospital mortality crude rate was 36.8%. This study is the first providing extensive data on hospitalisations in patients with pulmonary fibrosis, mostly idiopathic, in France, demonstrating high burden and hospital cost.