Connective tissue disease-associated interstitial lung disease and outcomes after hospitalization: A cohort study.

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Citation: Respiratory Medicine. 154:1-5, 2019 Jul - Aug.PMID: 31176795Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Connective Tissue Diseases/co [Complications] | *Hospitalization/sn [Statistics & Numerical Data] | *Lung Diseases, Interstitial/co [Complications] | Adult | Aged | Case-Control Studies | Cohort Studies | Connective Tissue Diseases/ep [Epidemiology] | Connective Tissue Diseases/mo [Mortality] | Female | Hospitalization/td [Trends] | Humans | Lung Diseases, Interstitial/ep [Epidemiology] | Lung Diseases, Interstitial/mo [Mortality] | Lung Transplantation/mo [Mortality] | Male | Middle Aged | Non-Randomized Controlled Trials as Topic | Outcome Assessment, Health Care | Retrospective Studies | Risk Assessment | Survival Analysis | Tertiary Care CentersYear: 2019ISSN:
  • 0954-6111
Name of journal: Respiratory medicineAbstract: BACKGROUND: The impact of hospitalization on patient outcomes is increasingly recognized and considered in the prognostication of many pulmonary disorders. We sought to evaluate the impact of hospitalization on survival in connective tissue disease-interstitial lung disease (CTD-ILD) patients.CONCLUSION: This study highlights the impact of hospitalization on subsequent outcomes in the CTD-ILD population with a significantly reduced transplant-free survival demonstrated, especially after cardiopulmonary hospitalization events.Copyright Published by Elsevier Ltd.METHODS: A chart review of patients with CTD-ILD followed at a tertiary care center was performed. Patients were stratified into two groups based on hospitalization status. Outcomes of the groups were compared using Kaplan-Meier survival analyses as well as multivariate competing risk analysis.RESULTS: There were 137 patients identified with confirmed CTD-ILD. Patients who underwent hospitalization for any reason had a significant decrease in transplant-free survival compared to the never hospitalized cohort (3-year survival 60% vs. 94%; p=0.0001). Hospitalization for >=7 days was associated with worse outcomes than those hospitalized for <7 days (median survival 1.59 years vs. 7.17 years, p=0.0012). Based on multivariate competing risk analysis, factors associated with death, with lung transplantation as a competing risk, were age (HR=1.05 [95% 1.01-1.09]; P=0.0443), male gender (HR=4.94 [95% CI: 1.58-15.41]; P=0.006), and all cause hospitalization (HR=11.97 [95% CI: 1.36-105.49]; P=0.0253).All authors: Ahmad KI, Barnett SD, Brown AW, Nathan SD, Ratwani APOriginally published: Respiratory Medicine. 154:1-5, 2019 Jul - Aug.Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2019-06-21
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Journal Article MedStar Authors Catalog Article 31176795 Available 31176795

BACKGROUND: The impact of hospitalization on patient outcomes is increasingly recognized and considered in the prognostication of many pulmonary disorders. We sought to evaluate the impact of hospitalization on survival in connective tissue disease-interstitial lung disease (CTD-ILD) patients.

CONCLUSION: This study highlights the impact of hospitalization on subsequent outcomes in the CTD-ILD population with a significantly reduced transplant-free survival demonstrated, especially after cardiopulmonary hospitalization events.

Copyright Published by Elsevier Ltd.

METHODS: A chart review of patients with CTD-ILD followed at a tertiary care center was performed. Patients were stratified into two groups based on hospitalization status. Outcomes of the groups were compared using Kaplan-Meier survival analyses as well as multivariate competing risk analysis.

RESULTS: There were 137 patients identified with confirmed CTD-ILD. Patients who underwent hospitalization for any reason had a significant decrease in transplant-free survival compared to the never hospitalized cohort (3-year survival 60% vs. 94%; p=0.0001). Hospitalization for >=7 days was associated with worse outcomes than those hospitalized for <7 days (median survival 1.59 years vs. 7.17 years, p=0.0012). Based on multivariate competing risk analysis, factors associated with death, with lung transplantation as a competing risk, were age (HR=1.05 [95% 1.01-1.09]; P=0.0443), male gender (HR=4.94 [95% CI: 1.58-15.41]; P=0.006), and all cause hospitalization (HR=11.97 [95% CI: 1.36-105.49]; P=0.0253).

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