Inpatient outcomes of patients with idiopathic pulmonary fibrosis admitted for pneumonia: results from the national inpatient sample

SESSION TITLE: Diffuse Lung Disease Posters 5 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Acute respiratory failure in Idiopathic Pulmonary Fibrosis (IPF) is associated with high in-hospital mortality upward of 50%. Evidence suggests that an acute event (e.g., infection, micro aspiration, or mechanical trauma) triggers widespread acute lung injury and precipitates acceleration of the underlying chronic factors contributing to the fibrotic process. This results in new bilateral abnormalities on radiology and diffuse alveolar damage on histology. Clinically, these patients have increased oxygen requirements that can often times necessitate mechanical ventilation. With this study, we aimed to determine the outcomes of patients with IPF who were admitted for pneumonia. METHODS: We used weighted data from National Inpatient Sample (NIS) database years 2018-2019 to analyze hospital admissions with a principal diagnosis of pneumonia, including all ICD codes with identifiable causes of pneumonia and ICD codes for unspecified causes of pneumonia and compared outcomes of patients with a secondary diagnosis of idiopathic pulmonary fibrosis (IPF). Primary outcomes were in-patient mortality due to any cause and need for mechanical ventilation. Secondary outcomes included length of stay (LOS) and total hospital charges (THCH). We matched baseline characteristics and used multivariate logistic and linear regression to adjust for cofounders. RESULTS: There was a total of 1,405,699 weighted admission with a principal diagnosis of pneumonia. 17% of which were attributable to bacterial pneumonia, 7.1% with pneumonia related to influenza virus, 3% with pneumonia from other viral causes and 72.9% with unspecified pneumonia. Prevalence of IPF was 1.7% of all cases of pneumonia and pooled mortality was 0.05%. After adjusting for cofounders, we found that patients with IPF had a higher change of dying with an adjusted odds ratio of (aOR) of 2.39, 95% CI: 1.21 – 4.71, p=0.011. There was no statistically significant difference in the need for mechanical ventilation with an aOR 0.96, 95% CI: 0.20 – 4.56, p=0.96. Patients with IPF had longer LOS 5.4 days compared to 4.49 in those without IPF, although this difference was not statistically significant p=0.81. THCH for IPF patients on average was 10,872$ higher than patients without IPF, this was not statistically significant p=0.26. CONCLUSIONS: Our study demonstrates that patients with IPF who are hospitalized for pneumonia have an increased in hospital mortality when compared to patients without IPF who are hospitalized for pneumonia. There is a trend towards increased duration of hospital stay and increased cost of hospitalization, albiet not statistically significant. Interestingly, having an underlying diagnosis of IPF did not appear to increase the need for mechanical ventilation in patients with pneumonia. CLINICAL IMPLICATIONS: IPF is an independent risk factor for death from any cause in patients admitted to the hospital for pneumonia, but is not associated with higher risk of mechanical ventilation. DISCLOSURES: No relevant relationships by Oluyemisi Amoda No relevant relationships by Afsana Asharaf No relevant relationships by Diana Gomez Manjarres No relevant relationships by Johnassis Jimenez No relevant relationships Added 10/20/2022 by Divya Patel, source=Web Response, value=Consulting fee Removed 12/06/2022 by Divya Patel, source=Web Response No relevant relationships Added 10/20/2022 by Divya Patel, source=Web Response, value=Grant/Research Support Removed 12/06/2022 by Divya Patel, source=Web Response No relevant relationships by Jean Reinoso