Respiratory Research (Jan 2024)

Hospitalisation patterns in interstitial lung diseases: data from the EXCITING-ILD registry

  • Katharina Buschulte,
  • Hans-Joachim Kabitz,
  • Lars Hagmeyer,
  • Peter Hammerl,
  • Albert Esselmann,
  • Conrad Wiederhold,
  • Dirk Skowasch,
  • Christoph Stolpe,
  • Marcus Joest,
  • Stefan Veitshans,
  • Marc Höffgen,
  • Phillen Maqhuzu,
  • Larissa Schwarzkopf,
  • Andreas Hellmann,
  • Michael Pfeifer,
  • Jürgen Behr,
  • Rainer Karpavicius,
  • Andreas Günther,
  • Markus Polke,
  • Philipp Höger,
  • Vivien Somogyi,
  • Christoph Lederer,
  • Philipp Markart,
  • Michael Kreuter

DOI
https://doi.org/10.1186/s12931-023-02588-y
Journal volume & issue
Vol. 25, no. 1
pp. 1 – 11

Abstract

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Abstract Background Interstitial lung diseases (ILD) comprise a heterogeneous group of mainly chronic lung diseases with more than 200 entities and relevant differences in disease course and prognosis. Little data is available on hospitalisation patterns in ILD. Methods The EXCITING-ILD (Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases) registry was analysed for hospitalisations. Reasons for hospitalisation were classified as all cause, ILD-related and respiratory hospitalisations, and patients were analysed for frequency of hospitalisations, time to first non-elective hospitalisation, mortality and progression-free survival. Additionally, the risk for hospitalisation according to GAP index and ILD subtype was calculated by Cox proportional-hazard models as well as influencing factors on prediction of hospitalisation by logistic regression with forward selection. Results In total, 601 patients were included. 1210 hospitalisations were recorded during the 6 months prior to registry inclusion until the last study visit. 800 (66.1%) were ILD-related, 59.3% of admissions were registered in the first year after inclusion. Mortality was associated with all cause, ILD-related and respiratory-related hospitalisation. Risk factors for hospitalisation were advanced disease (GAP Index stages II and III) and CTD (connective tissue disease)-ILDs. All cause hospitalisations were associated with pulmonary hypertension (OR 2.53, p = 0.005). ILD-related hospitalisations were associated with unclassifiable ILD and concomitant emphysema (OR = 2.133, p = 0.001) as well as with other granulomatous ILDs and a positive smoking status (OR = 3.082, p = 0.005). Conclusion Our results represent a crucial contribution in understanding predisposing factors for hospitalisation in ILD and its major impact on mortality. Further studies to characterize the most vulnerable patient group as well as approaches to prevent hospitalisations are warranted.

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