Sex Differences in the Incidence and Outcomes of Patients Hospitalized by Idiopathic Pulmonary Fibrosis (IPF) in Spain from 2016 to 2019
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Source
2.2. Study Population
2.3. Study Variables
2.4. Propensity Score Matching
2.5. Statistical Analysis
2.6. Sensitivity Analysis
2.7. Ethical Aspects
3. Results
Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- American Thoracic Society; European Respiratory Society. Idiopathic pulmonary fibrosis: Diagnosis and treatment. International consensus statement. American Thoraci Society (ATS), and the European Respiratory Society (ERS). Am. J. Respir. Crit. Care Med. 2000, 161, 646–664. [Google Scholar] [CrossRef] [Green Version]
- Raghu, G.; Collard, H.R.; Egan, J.J.; Martinez, F.J.; Behr, J.; Brown, K.K.; Colby, T.V.; Cordier, J.-F.; Flaherty, K.R.; Lasky, J.A.; et al. An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management. Am. J. Respir. Crit. Care Med. 2011, 183, 788–824. [Google Scholar] [CrossRef] [PubMed]
- Raghu, G.; Remy-Jardin, M.; Myers, J.L.; Richeldi, L.; Ryerson, C.J.; Lederer, D.J.; Behr, J.; Cottin, V.; Danoff, S.K.; Morell, F.; et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am. J. Respir. Crit. Care Med. 2018, 198, e44–e68. [Google Scholar] [CrossRef] [PubMed]
- Ley, B.; Collard, H.R.; King, T.E. Clinical Course and Prediction of Survival in Idiopathic Pulmonary Fibrosis. Am. J. Respir. Crit. Care Med. 2011, 183, 431–440. [Google Scholar] [CrossRef] [PubMed]
- Xaubet, A.; Ancochea, J.; Bollo, E.; Fernández-Fabrellas, E.; Franquet, T.; Molina, M.M.; Montero, M.A.; Serrano-Mollar, A. Normativa sobre el diagnóstico y tratamiento de la fibrosis pulmonar idiopática. Arch. Bronconeumol. 2013, 49, 343–353. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Meyer, K.C. Pulmonary fibrosis, part I: Epidemiology, pathogenesis, and diagnosis. Expert Rev. Respir. Med. 2017, 11, 343–359. [Google Scholar] [CrossRef]
- Hutchinson, J.P.; Fogarty, A.; Hubbard, R.B.; McKeever, T. Global incidence and mortality of idiopathic pulmonary fibrosis: A systematic review. Eur. Respir. J. 2015, 46, 795–806. [Google Scholar] [CrossRef] [Green Version]
- Raghu, G.; Weycker, D.; Edelsberg, J.; Bradford, W.Z.; Oster, G. Incidence and Prevalence of Idiopathic Pulmonary Fibrosis. Am. J. Respir. Crit. Care Med. 2006, 174, 810–816. [Google Scholar] [CrossRef]
- Navaratnam, V.; Fleming, K.M.; West, J.; Smith, C.J.P.; Jenkins, G.; Fogarty, A.; Hubbard, R.B. The rising incidence of idiopathic pulmonary fibrosis in the UK. Thorax 2011, 66, 462–467. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Marshall, D.C.; Salciccioli, J.D.; Shea, B.S.; Akuthota, P. Trends in mortality from idiopathic pulmonary fibrosis in the European Union: An observational study of the WHO mortality database from 2001–2013. Eur. Respir. J. 2018, 51, 1701603. [Google Scholar] [CrossRef] [Green Version]
- Farrand, E.; Iribarren, C.; Vittinghoff, E.; Levine-Hall, T.; Ley, B.; Minowada, G.; Collard, H.R. Impact of Idiopathic Pulmonary Fibrosis on Longitudinal Health-care Utilization in a Community-Based Cohort of Patients. Chest 2021, 159, 219–227. [Google Scholar] [CrossRef]
- Collard, H.R.; Chen, S.-Y.; Yeh, W.-S.; Li, Q.; Lee, Y.-C.; Wang, A.; Raghu, G. Health Care Utilization and Costs of Idiopathic Pulmonary Fibrosis in U.S. Medicare Beneficiaries Aged 65 Years and Older. Ann. Am. Thorac. Soc. 2015, 12, 981–987. [Google Scholar] [CrossRef]
- Ministerio de Sanidad, Servicios Sociales e Igualdad. Real Decreto 69/2015, de 6 de febrero, por el que se regula el Registro de Actividad de Atención Sanitaria Especializada. (Spanish National Hospital Discharge Database). BOE 2015, 35, 10789–10809. Available online: https://www.mscbs.gob.es/estadEstudios/estadisticas/docs/BOE_RD_69_2015_RAE_CMBD.pdf (accessed on 29 April 2021).
- Instituto Nacional de Estadistica. Population Estimations. Available online: https://www.ine.es/jaxiT3/Tabla.htm?t=31304 (accessed on 16 March 2021). (In Spanish)
- Sundararajan, V.; Henderson, T.; Perry, C.; Muggivan, A.; Quan, H.; Ghali, W.A. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J. Clin. Epidemiol. 2004, 57, 1288–1294. [Google Scholar] [CrossRef]
- Austin, P.C. Comparing paired vs non-paired statistical methods of analyses when making inferences about absolute risk reductions in propensity-score matched samples. Stat. Med. 2011, 30, 1292–1301. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hosmer, D.W.; Lemeshow, S.; Sturdivant, R.X. Applied Logistic Regression, 3rd ed.; John Wiley & Sons, Inc.: Hoboken, NJ, USA, 2013. [Google Scholar]
- Kim, E.J.; Collard, H.R.; King, T.E., Jr. Rheumatoid Arthritis-Associated Interstitial Lung Disease: The Relevance of Histopathologic and Radiographic Pattern. Chest 2009, 136, 1397–1405. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ministerio de Sanidad, Consumo y Bienestar Social. Solicitud de Extracción de Datos—Extraction Request (Spanish National Hospital Discharge Database). Available online: https://www.mscbs.gob.es/estadEstudios/estadisticas/estadisticas/estMinisterio/SolicitudCMBDdocs/2018_Formulario_Peticion_Datos_RAE_CMBD.pdf (accessed on 28 January 2021).
- Oh, C.K.; Murray, L.A.; Molfino, N.A. Smoking and Idiopathic Pulmonary Fibrosis. Pulm. Med. 2012, 2012, 808260. [Google Scholar] [CrossRef]
- Bade, B.C.; DeRycke, E.C.; Ramsey, C.; Skanderson, M.; Crothers, K.; Haskell, S.; Bean-Mayberry, B.; Brandt, C.; Bastian, L.A.; Akgün, K.M. Sex Differences in Veterans Admitted to the Hospital for Chronic Obstructive Pulmonary Disease Exacerbation. Ann. Am. Thorac. Soc. 2019, 16, 707–714. [Google Scholar] [CrossRef]
- Zaman, T.; Moua, T.; Vittinghoff, E.; Ryu, J.H.; Collard, H.R.; Lee, J.S. Differences in Clinical Characteristics and Outcomes Between Men and Women With Idiopathic Pulmonary Fibrosis: A multicenter retrospective cohort study. Chest 2020, 158, 245–251. [Google Scholar] [CrossRef] [PubMed]
- Hopkins, R.B.; Burke, N.; Fell, C.; Dion, G.; Kolb, M. Epidemiology and survival of idiopathic pulmonary fibrosis from national data in Canada. Eur. Respir. J. 2016, 48, 187–195. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Raghu, G.; Chen, S.-Y.; Hou, Q.; Yeh, W.-S.; Collard, H.R. Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18–64 years old. Eur. Respir. J. 2016, 48, 179–186. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Esposito, D.B.; Lanes, S.; Donneyong, M.; Holick, C.N.; Lasky, J.A.; Lederer, D.; Nathan, S.D.; O’Quinn, S.; Parker, J.; Tran, T.N. Idiopathic Pulmonary Fibrosis in United States Automated Claims. Incidence, Prevalence, and Algorithm Validation. Am. J. Respir. Crit. Care Med. 2015, 192, 1200–1207. [Google Scholar] [CrossRef] [PubMed]
- Raghu, G.; Chen, S.-Y.; Yeh, W.-S.; Maroni, B.; Li, Q.; Lee, Y.-C.; Collard, H.R. Idiopathic pulmonary fibrosis in US Medicare beneficiaries aged 65 years and older: Incidence, prevalence, and survival, 2001–2011. Lancet Respir. Med. 2014, 2, 566–572. [Google Scholar] [CrossRef]
- Fernández-Fabrellas, E.; Molina-Molina, M.; Soriano, J.B.; Portal, J.A.R.; Ancochea, J.; Valenzuela, C.; Xaubet, A.; SEPAR-IPF National Registry. Demographic and clinical profile of idiopathic pulmonary fibrosis patients in Spain: The SEPAR National Registry. Respir. Res. 2019, 20, 127. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cottin, V.; Nunes, H.; Brillet, P.-Y.; Delaval, P.; Devouassaoux, G.; Tillie-Leblond, I.; Israel-Biet, D.; Court-Fortune, I.; Valeyre, D.; Cordier, J.-F. Combined pulmonary fibrosis and emphysema: A distinct underrecognised entity. Eur. Respir. J. 2005, 26, 586–593. [Google Scholar] [CrossRef]
- Papaioannou, A.I.; Kostikas, K.; Manali, E.D.; Papadaki, G.; Roussou, A.; Kolilekas, L.; Borie, R.; Bouros, D.; Papiris, S.A. Combined pulmonary fibrosis and emphysema: The many aspects of a cohabitation contract. Respir. Med. 2016, 117, 14–26. [Google Scholar] [CrossRef]
- Torrisi, S.E.; Vancheri, A.; Pavone, M.; Sambataro, G.; Palmucci, S.; Vancheri, C. Comorbidities of IPF: How do they impact on prognosis. Pulm. Pharmacol. Ther. 2018, 53, 6–11. [Google Scholar] [CrossRef]
- Ryerson, C.J.; Hartman, T.; Elicker, B.M.; Ley, B.; Lee, J.S.; Abbritti, M.; Jones, K.D.; King, T.E.; Ryu, J.; Collard, H.R. Clinical Features and Outcomes in Combined Pulmonary Fibrosis and Emphysema in Idiopathic Pulmonary Fibrosis. Chest 2013, 144, 234–240. [Google Scholar] [CrossRef]
- Otsuka, H.; Sugino, K.; Hata, Y.; Makino, T.; Koezuka, S.; Isobe, K.; Tochigi, N.; Shibuya, K.; Homma, S.; Iyoda, A. Clinical features and outcomes of patients with lung cancer as well as combined pulmonary fibrosis and emphysema. Mol. Clin. Oncol. 2016, 5, 273–278. [Google Scholar] [CrossRef] [Green Version]
- Ye, Q.; Huang, K.; Ding, Y.; Lou, B.; Hou, Z.; Dai, H.; Wang, C. Cigarette smoking contributes to idiopathic pulmonary fibrosis associated with emphysema. Chin. Med. J. Engl. 2014, 127, 469–474. [Google Scholar]
- Enomoto, T.; Usuki, J.; Azuma, A.; Nakagawa, T.; Kudoh, S. Diabetes Mellitus May Increase Risk for Idiopathic Pulmonary Fibrosis. Chest 2003, 123, 2007–2011. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wang, D.; Ma, Y.; Tong, X.; Zhang, Y.; Fan, H. Diabetes Mellitus Contributes to Idiopathic Pulmonary Fibrosis: A Review from Clinical Appearance to Possible Pathogenesis. Front. Public Health 2020, 8, 196. [Google Scholar] [CrossRef]
- Hubbard, R.B.; Smith, C.; Le Jeune, I.; Gribbin, J.; Fogarty, A.W. The Association between Idiopathic Pulmonary Fibrosis and Vascular Disease: A population-based study. Am. J. Respir. Crit. Care Med. 2008, 178, 1257–1261. [Google Scholar] [CrossRef] [PubMed]
- Nathan, S.D.; Basavaraj, A.; Reichner, C.; Shlobin, O.A.; Ahmad, S.; Kiernan, J.; Burton, N.; Barnett, S.D. Prevalence and impact of coronary artery disease in idiopathic pulmonary fibrosis. Respir. Med. 2010, 104, 1035–1041. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alqalyoobi, S.; Pérez, E.R.F.; Oldham, J.M. In-hospital mortality trends among patients with idiopathic pulmonary fibrosis in the United States between 2013-2017: A comparison of academic and non-academic programs. BMC Pulm. Med. 2020, 20, 289. [Google Scholar] [CrossRef] [PubMed]
- Meyer, K.C.; Danoff, S.K.; Lancaster, L.H.; Nathan, S.D. Management of Idiopathic Pulmonary Fibrosis in the Elderly Patient. Chest 2015, 148, 242–252. [Google Scholar] [CrossRef]
- Ozawa, Y.; Suda, T.; Naito, T.; Enomoto, N.; Hashimoto, D.; Fujisawa, T.; Nakamura, Y.; Inui, N.; Nakamura, H.; Chida, K. Cumulative incidence of and predictive factors for lung cancer in IPF. Respirology 2009, 14, 723–728. [Google Scholar] [CrossRef]
- Tomassetti, S.; Gurioli, C.; Ryu, J.; Decker, P.A.; Ravaglia, C.; Tantalocco, P.; Buccioli, M.; Piciucchi, S.; Sverzellati, N.; Dubini, A.; et al. The Impact of Lung Cancer on Survival of Idiopathic Pulmonary Fibrosis. Chest 2015, 147, 157–164. [Google Scholar] [CrossRef]
- Jeganathan, N.; Smith, R.A.; Sathananthan, M. Mortality Trends of Idiopathic Pulmonary Fibrosis in the United States from 2004 Through 2017. Chest 2021, 159, 228–238. [Google Scholar] [CrossRef]
- Olson, A.L.; Swigris, J.J.; Lezotte, D.C.; Norris, J.M.; Wilson, C.G.; Brown, K.K. Mortality from Pulmonary Fibrosis Increased in the United States from 1992 to 2003. Am. J. Respir. Crit. Care Med. 2007, 176, 277–284. [Google Scholar] [CrossRef] [Green Version]
- Dove, E.P.; Olson, A.; Glassberg, M.K. Trends in Idiopathic Pulmonary Fibrosis–related Mortality in the United States: 2000–2017. Am. J. Respir. Crit. Care Med. 2019, 200, 929–931. [Google Scholar] [CrossRef]
- Navaratnam, V.; Davis, T.M.E.; Hubbard, R.; Davis, W.A. Incidence and predictors of idiopathic pulmonary fibrosis complicating Type 2 diabetes: The Fremantle Diabetes Study Phase I. Intern. Med. J. 2021, 51, 276–279. [Google Scholar] [CrossRef]
- Hyldgaard, C.; Hilberg, O.; Bendstrup, E. How does comorbidity influence survival in idiopathic pulmonary fibrosis? Respir. Med. 2014, 108, 647–653. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Harari, S.; Madotto, F.; Caminati, A.; Conti, S.; Cesana, G. Epidemiology of Idiopathic Pulmonary Fibrosis in Northern Italy. PLoS ONE 2016, 11, e0147072. [Google Scholar] [CrossRef] [PubMed]
- Ferrara, G.; Arnheim-Dahlström, L.; Bartley, K.; Janson, C.; Kirchgässler, K.-U.; Levine, A.; Sköld, C.M. Epidemiology of Pulmonary Fibrosis: A Cohort Study Using Healthcare Data in Sweden. Pulm. Ther. 2019, 5, 55–68. [Google Scholar] [CrossRef] [Green Version]
- Oda, K.; Yatera, K.; Fujino, Y.; Kido, T.; Hanaka, T.; Sennari, K.; Fushimi, K.; Matsuda, S.; Mukae, H. Respiratory comorbidities and risk of mortality in hospitalized patients with idiopathic pulmonary fibrosis. Respir. Investig. 2018, 56, 64–71. [Google Scholar] [CrossRef]
- Ley, B.; Urbania, T.; Husson, G.; Vittinghoff, E.; Brush, D.R.; Eisner, M.D.; Iribarren, C.; Collard, H.R. Code-based Diagnostic Algorithms for Idiopathic Pulmonary Fibrosis. Case Validation and Improvement. Ann. Am. Thorac. Soc. 2017, 14, 880–887. [Google Scholar] [CrossRef]
- Caminati, A.; Madotto, F.; Cesana, G.; Conti, S.; Harari, S. Epidemiological studies in IPF: Pitfalls in methodologies and data interpretation. Eur. Respir. Rev. 2015, 24, 436–444. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Primary | Secondary | Both | |||||||
---|---|---|---|---|---|---|---|---|---|
Men | Women | p-Value | Men | Women | p-Value | Men | Women | p-Value | |
Incidence (2016–2019), n (Inc/105) | 2998 (4.03) | 1296 (1.64) | <0.001 | 5825 (7.82) | 3159 (4) | <0.001 | 8823 (11.85) | 4455 (5.64) | <0.001 |
2016, n (%) | 714 (23.82) | 361 (27.85) | 0.005 | 1329 (22.82) | 828 (26.21) | <0.001 | 2043 (23.16) | 1189 (26.69) | <0.001 |
2017, n (%) | 811 (27.05) | 372 (28.7) | 0.266 | 1601 (27.48) | 937 (29.66) | 0.028 | 2412 (27.34) | 1309 (29.38) | 0.013 |
2018, n (%) | 681 (22.72) | 282 (21.76) | 0.490 | 1454 (24.96) | 678 (21.46) | <0.001 | 2135 (24.2) | 960 (21.55) | 0.001 |
2019, n (%) | 792 (26.42) | 281 (21.68) | 0.001 | 1441 (24.74) | 716 (22.67) | 0.028 | 2233 (25.31) | 997 (22.38) | <0.001 |
Age 18–59 years, n (%) | 355 (11.84) | 122 (9.41) | 0.020 | 370 (6.35) | 169 (5.35) | 0.056 | 725 (8.22) | 291 (6.53) | 0.001 |
Age 60–69 years, n (%) | 835 (27.85) | 265 (20.45) | <0.001 | 993 (17.05) | 336 (10.64) | <0.001 | 1828 (20.72) | 601 (13.49) | <0.001 |
Age 70–79 years, n (%) | 1111 (37.06) | 388 (29.94) | <0.001 | 2057 (35.31) | 882 (27.92) | <0.001 | 3168 (35.91) | 1270 (28.51) | <0.001 |
Age 80 year or over, n (%) | 697 (23.25) | 521 (40.2) | <0.001 | 2405 (41.29) | 1772 (56.09) | <0.001 | 3102 (35.16) | 2293 (51.47) | <0.001 |
Primary | Secondary | Both | |||||||
---|---|---|---|---|---|---|---|---|---|
Men | Women | p-Value | Men | Women | p-Value | Men | Women | p-Value | |
Age, mean (SD) | 71.69 (10.4) | 74.7 (11.22) | <0.001 | 76.06 (10.21) | 78.91 (10.44) | <0.001 | 74.58 (10.48) | 77.68 (10.84) | <0.001 |
CCI, mean (SD) | 1.15 (1.38) | 0.94 (0.92) | <0.001 | 2.15 (2) | 1.67 (1.57) | <0.001 | 1.81 (1.77) | 1.46 (1.41) | <0.001 |
Myocardial infarction, n (%) | 203 (6.77) | 9 (0.69) | <0.001 | 528 (9.06) | 135 (4.27) | <0.001 | 731 (8.29) | 144 (3.23) | <0.001 |
Congestive heart failure, n (%) | 434 (14.48) | 190 (14.66) | 0.875 | 1379 (23.67) | 962 (30.45) | <0.001 | 1813 (20.55) | 1152 (25.86) | <0.001 |
Peripheral vascular disease, n (%) | 163 (5.44) | 11 (0.85) | <0.001 | 528 (9.06) | 94 (2.98) | <0.001 | 691 (7.83) | 105 (2.36) | <0.001 |
Cerebrovascular disease, n (%) | 62 (2.07) | 33 (2.55) | 0.328 | 321 (5.51) | 191 (6.05) | 0.296 | 383 (4.34) | 224 (5.03) | 0.073 |
Dementia, n (%) | 38 (1.27) | 32 (2.47) | 0.004 | 205 (3.52) | 217 (6.87) | <0.001 | 243 (2.75) | 249 (5.59) | <0.001 |
Chronic pulmonary disease, n (%) | 653 (21.78) | 237 (18.29) | 0.010 | 1809 (31.06) | 670 (21.21) | <0.001 | 2462 (27.9) | 907 (20.36) | <0.001 |
Rheumatoid disease, n (%) | 51 (1.7) | 50 (3.86) | <0.001 | 187 (3.21) | 261 (8.26) | <0.001 | 238 (2.7) | 311 (6.98) | <0.001 |
Peptic ulcer disease, n (%) | 18 (0.6) | 5 (0.39) | 0.376 | 35 (0.6) | 13 (0.41) | 0.240 | 53 (0.6) | 18 (0.4) | 0.142 |
Mild liver disease, n (%) | 148 (4.94) | 54 (4.17) | 0.274 | 297 (5.1) | 123 (3.89) | 0.010 | 445 (5.04) | 177 (3.97) | 0.006 |
Diabetes, n (%) | 693 (23.12) | 242 (18.67) | 0.001 | 1598 (27.43) | 731 (23.14) | <0.001 | 2291 (25.97) | 973 (21.84) | <0.001 |
Diabetes with complications, n (%) | 34 (1.13) | 15 (1.16) | 0.947 | 184 (3.16) | 66 (2.09) | 0.003 | 218 (2.47) | 81 (1.82) | 0.017 |
Hemiplegia or paraplegia, n (%) | 5 (0.17) | 1 (0.08) | 0.470 | 29 (0.5) | 22 (0.7) | 0.232 | 34 (0.39) | 23 (0.52) | 0.276 |
Renal disease, n (%) | 240 (8.01) | 111 (8.56) | 0.539 | 1027 (17.63) | 550 (17.41) | 0.793 | 1267 (14.36) | 661 (14.84) | 0.461 |
Cancer, n (%) | 83 (2.77) | 21 (1.62) | 0.025 | 525 (9.01) | 125 (3.96) | <0.001 | 608 (6.89) | 146 (3.28) | <0.001 |
Metastatic solid tumor, n (%) | 31 (1.03) | 6 (0.46) | 0.063 | 285 (4.89) | 44 (1.39) | <0.001 | 316 (3.58) | 50 (1.12) | <0.001 |
Moderate or severe liver disease, n (%) | 17 (0.57) | 9 (0.69) | 0.621 | 114 (1.96) | 26 (0.82) | <0.001 | 131 (1.48) | 35 (0.79) | 0.001 |
AIDS/HIV, n (%) | 2 (0.07) | 0 (0) | 0.352 | 9 (0.15) | 1 (0.03) | 0.095 | 11 (0.12) | 1 (0.02) | 0.064 |
Pulmonary embolism, n (%) | 34 (1.13) | 10 (0.77) | 0.279 | 114 (1.96) | 43 (1.36) | 0.040 | 148 (1.68) | 53 (1.19) | 0.030 |
Pulmonary hypertension, n (%) | 394 (13.14) | 179 (13.81) | 0.554 | 601 (10.32) | 424 (13.42) | <0.001 | 995 (11.28) | 603 (13.54) | <0.001 |
Pneumonia, n (%) | 90 (3) | 48 (3.7) | 0.231 | 806 (13.84) | 380 (12.03) | 0.016 | 896 (10.16) | 428 (9.61) | 0.320 |
Tobacco use, n% | 1546 (51.57) | 151 (11.65) | <0.001 | 2829 (48.57) | 288 (9.12) | <0.001 | 4375 (49.59) | 439 (9.85) | <0.001 |
Oxygen prior to hospitalization, n (%) | 929 (30.99) | 394 (30.4) | 0.703 | 1497 (25.7) | 916 (29) | 0.001 | 2426 (27.5) | 1310 (29.41) | 0.021 |
Noninvasive ventilation, n (%) | 104 (3.47) | 28 (2.16) | 0.023 | 154 (2.64) | 81 (2.56) | 0.821 | 258 (2.92) | 109 (2.45) | 0.113 |
Invasive ventilation, n (%) | 111 (3.7) | 24 (1.85) | 0.001 | 140 (2.4) | 41 (1.3) | <0.001 | 251 (2.84) | 65 (1.46) | <0.001 |
Computed tomography of the chest, n (%) | 466 (15.54) | 183 (14.12) | 0.232 | 570 (9.79) | 253 (8.01) | 0.005 | 1036 (11.74) | 436 (9.79) | 0.001 |
Respiratory function tests, n (%) | 97 (3.24) | 38 (2.93) | 0.601 | 60 (1.03) | 36 (1.14) | 0.630 | 157 (1.78) | 74 (1.66) | 0.622 |
Bronchoscopy, n (%) | 140 (4.67) | 36 (2.78) | 0.004 | 98 (1.68) | 24 (0.76) | <0.001 | 238 (2.7) | 60 (1.35) | <0.001 |
Lung scintigraphy, n (%) | 25 (0.83) | 6 (0.46) | 0.188 | 2 (0.03) | 2 (0.06) | 0.534 | 27 (0.31) | 8 (0.18) | 0.180 |
Lung transplant, n (%) | 154 (5.14) | 29 (2.24) | <0.001 | 8 (0.14) | 2 (0.06) | 0.315 | 162 (1.84) | 31 (0.7) | <0.001 |
Length of stay, median (IQR) | 7 (8) | 7 (7) | 0.066 | 7 (7) | 7 (7) | 0.670 | 7 (7) | 7 (7) | 0.150 |
In-hospital mortality, n (%) | 539 (17.98) | 183 (14.12) | 0.002 | 914 (15.69) | 421 (13.33) | 0.003 | 1453 (16.47) | 604 (13.56) | <0.001 |
Primary | Secondary | Both | |||||||
---|---|---|---|---|---|---|---|---|---|
Men | Women | p-Value | Men | Women | p-Value | Men | Women | p-Value | |
Age, mean (SD) | 74.28 (10.27) | 74.7 (11.22) | 0.317 | 78.74 (9.17) | 78.91 (10.44) | 0.497 | 77.4 (9.73) | 77.68 (10.84) | 0.187 |
CCI, mean (SD) | 0.83 (0.79) | 0.94 (0.92) | 0.015 | 1.57 (1.47) | 1.67 (1.57) | 0.013 | 1.35 (1.28) | 1.46 (1.41) | 0.001 |
Myocardial infarction, n (%) | 32 (2.38) | 9 (0.69) | <0.001 | 105 (3.37) | 135 (4.27) | 0.063 | 137 (3.08) | 144 (3.23) | 0.671 |
Congestive heart failure, n (%) | 217 (16.16) | 190 (14.66) | 0.287 | 834 (26.8) | 962 (30.45) | 0.001 | 1051 (23.59) | 1152 (25.86) | 0.013 |
Peripheral vascular disease, n (%) | 13 (0.97) | 11 (0.85) | 0.747 | 86 (2.76) | 94 (2.98) | 0.615 | 99 (2.22) | 105 (2.36) | 0.671 |
Cerebrovascular disease, n (%) | 25 (1.86) | 33 (2.55) | 0.230 | 173 (5.56) | 191 (6.05) | 0.409 | 198 (4.44) | 224 (5.03) | 0.195 |
Dementia, n (%) | 22 (1.64) | 32 (2.47) | 0.132 | 176 (5.66) | 217 (6.87) | 0.047 | 198 (4.44) | 249 (5.59) | 0.013 |
Chronic pulmonary disease, n (%) | 223 (16.6) | 237 (18.29) | 0.255 | 703 (22.59) | 670 (21.21) | 0.186 | 926 (20.79) | 907 (20.36) | 0.619 |
Rheumatoid disease, n (%) | 44 (3.28) | 50 (3.86) | 0.420 | 153 (4.92) | 261 (8.26) | <0.001 | 197 (4.42) | 311 (6.98) | <0.001 |
Peptic ulcer disease, n (%) | 3 (0.22) | 5 (0.39) | 0.448 | 14 (0.45) | 13 (0.41) | 0.817 | 17 (0.38) | 18 (0.4) | 0.866 |
Mild liver disease, n (%) | 53 (3.95) | 54 (4.17) | 0.774 | 124 (3.98) | 123 (3.89) | 0.853 | 177 (3.97) | 177 (3.97) | 0.999 |
Diabetes, n (%) | 229 (17.05) | 242 (18.67) | 0.277 | 695 (22.33) | 731 (23.14) | 0.446 | 924 (20.74) | 973 (21.84) | 0.205 |
Diabetes with complications, n (%) | 6 (0.45) | 15 (1.16) | 0.040 | 55 (1.77) | 66 (2.09) | 0.354 | 61 (1.37) | 81 (1.82) | 0.091 |
Hemiplegia or paraplegia, n (%) | 4 (0.3) | 1 (0.08) | 0.192 | 17 (0.55) | 22 (0.7) | 0.450 | 21 (0.47) | 23 (0.52) | 0.762 |
Renal disease, n (%) | 81 (6.03) | 111 (8.56) | 0.012 | 525 (16.87) | 550 (17.41) | 0.570 | 606 (13.6) | 661 (14.84) | 0.095 |
Cancer, n (%) | 17 (1.27) | 21 (1.62) | 0.445 | 137 (4.4) | 125 (3.96) | 0.378 | 154 (3.46) | 146 (3.28) | 0.638 |
Metastatic solid tumor, n (%) | 5 (0.37) | 6 (0.46) | 0.718 | 49 (1.57) | 44 (1.39) | 0.552 | 54 (1.21) | 50 (1.12) | 0.693 |
Moderate or severe liver disease, n (%) | 4 (0.3) | 9 (0.69) | 0.146 | 20 (0.64) | 26 (0.82) | 0.403 | 24 (0.54) | 35 (0.79) | 0.151 |
AIDS/HIV, n (%) | 0 (0) | 0 (0) | NA | 0 (0) | 1 (0.03) | 0.321 | 0 (0) | 1 (0.02) | 0.317 |
Pulmonary embolism, n (%) | 7 (0.52) | 10 (0.77) | 0.422 | 70 (2.25) | 43 (1.36) | 0.008 | 77 (1.73) | 53 (1.19) | 0.034 |
Pulmonary hypertension, n (%) | 169 (12.58) | 179 (13.81) | 0.351 | 339 (10.89) | 424 (13.42) | 0.002 | 508 (11.4) | 603 (13.54) | 0.002 |
Pneumonia, n (%) | 30 (2.23) | 48 (3.7) | 0.026 | 497 (15.97) | 380 (12.03) | <0.001 | 527 (11.83) | 428 (9.61) | 0.001 |
Tobacco use, n% | 640 (47.65) | 151 (11.65) | <0.001 | 1415 (45.47) | 288 (9.12) | <0.001 | 2055 (46.13) | 439 (9.85) | <0.001 |
Oxygen prior to hospitalization, n (%) | 391 (29.11) | 394 (30.4) | 0.470 | 792 (25.45) | 916 (29) | 0.002 | 1183 (26.55) | 1310 (29.41) | 0.003 |
Noninvasive ventilation, n (%) | 30 (2.23) | 28 (2.16) | 0.898 | 71 (2.28) | 81 (2.56) | 0.467 | 101 (2.27) | 109 (2.45) | 0.576 |
Invasive ventilation, n (%) | 43 (3.2) | 24 (1.85) | 0.028 | 67 (2.15) | 41 (1.3) | 0.009 | 110 (2.47) | 65 (1.46) | 0.001 |
Computed tomography of the chest, n (%) | 216 (16.08) | 183 (14.12) | 0.159 | 258 (8.29) | 253 (8.01) | 0.684 | 474 (10.64) | 436 (9.79) | 0.184 |
Respiratory function tests, n (%) | 37 (2.76) | 38 (2.93) | 0.784 | 29 (0.93) | 36 (1.14) | 0.417 | 66 (1.48) | 74 (1.66) | 0.496 |
Bronchoscopy, n (%) | 49 (3.65) | 36 (2.78) | 0.205 | 35 (1.12) | 24 (0.76) | 0.134 | 84 (1.89) | 60 (1.35) | 0.044 |
Lung scintigraphy, n (%) | 9 (0.67) | 6 (0.46) | 0.479 | 1 (0.03) | 2 (0.06) | 0.572 | 10 (0.22) | 8 (0.18) | 0.637 |
Lung transplant, n (%) | 59 (4.39) | 29 (2.24) | 0.002 | 3 (0.1) | 2 (0.06) | 0.643 | 62 (1.39) | 31 (0.7) | 0.001 |
Length of stay, median (IQR) | 7 (8) | 7 (7) | 0.081 | 7 (7) | 7 (7) | 0.757 | 7 (7) | 7 (7) | 0.495 |
In-hospital mortality, n (%) | 248 (18.47) | 183 (14.12) | 0.003 | 509 (16.36) | 421 (13.33) | 0.001 | 757 (16.99) | 604 (13.56) | <0.001 |
Primary | ||
---|---|---|
Men | Women | |
Age 18–59 years | 1.58 (1.01–2.47) | 3.58 (1.18–10.92) |
Age 60–69 years | 2.62 (1.69–4.05) | 6.26 (2.1–18.72) |
Age 70–79 years | 3.29 (2.1–5.15) | 7.28 (2.46–21.55) |
Myocardial infarction | NS | NS |
Congestive heart failure | NS | 1.2 (1.01–1.43) |
Chronic pulmonary disease | NS | NS |
Diabetes | NS | NS |
Hemiplegia or paraplegia | NS | NS |
Cancer | 3.73 (1.75–7.93) | 2.57 (1.37–4.83) |
Pulmonary hypertension | NS | NS |
Pneumonia | 2.44 (1.52–3.91) | 5.98 (2.7–13.23) |
Oxygen prior to hospitalization | 1.37 (1.12–1.68) | 2.11 (1.05–4.23) |
Noninvasive ventilation | 4.36 (2.82–6.73) | 3.19 (1.04–9.73) |
Invasive ventilation | 5.55 (3.24–9.51) | 4.36 (2.19–10.68) |
Bronchoscopy | 0.42 (0.22–0.82) | NS |
Lung transplant | 0.46 (0.24–0.91) | NS |
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López-Muñiz Ballesteros, B.; López-Herranz, M.; Lopez-de-Andrés, A.; Hernandez-Barrera, V.; Jiménez-García, R.; Carabantes-Alarcon, D.; Jiménez-Trujillo, I.; de Miguel-Diez, J. Sex Differences in the Incidence and Outcomes of Patients Hospitalized by Idiopathic Pulmonary Fibrosis (IPF) in Spain from 2016 to 2019. J. Clin. Med. 2021, 10, 3474. https://doi.org/10.3390/jcm10163474
López-Muñiz Ballesteros B, López-Herranz M, Lopez-de-Andrés A, Hernandez-Barrera V, Jiménez-García R, Carabantes-Alarcon D, Jiménez-Trujillo I, de Miguel-Diez J. Sex Differences in the Incidence and Outcomes of Patients Hospitalized by Idiopathic Pulmonary Fibrosis (IPF) in Spain from 2016 to 2019. Journal of Clinical Medicine. 2021; 10(16):3474. https://doi.org/10.3390/jcm10163474
Chicago/Turabian StyleLópez-Muñiz Ballesteros, Belén, Marta López-Herranz, Ana Lopez-de-Andrés, Valentín Hernandez-Barrera, Rodrigo Jiménez-García, David Carabantes-Alarcon, Isabel Jiménez-Trujillo, and Javier de Miguel-Diez. 2021. "Sex Differences in the Incidence and Outcomes of Patients Hospitalized by Idiopathic Pulmonary Fibrosis (IPF) in Spain from 2016 to 2019" Journal of Clinical Medicine 10, no. 16: 3474. https://doi.org/10.3390/jcm10163474