IPF mortality in US decreased from 2004 to 2017

Age-adjusted mortality rates for idiopathic pulmonary fibrosis decreased from 2004 to 2017 in the United States, according to a new study published in CHEST.

“Previous studies reported a rise in IPF-related mortality rates in the United States from 1979 through 2003 and predicted a continued increase in the future,” Niranjan Jeganathan, MD, pulmonologist in the division of pulmonary, critical care, hyperbaric, allergy and sleep medicine at Loma Linda University Health in California, and colleagues wrote. “However, significant advances in the diagnosis and treatment of IPF have occurred since that have altered its prevalence in the United States and worldwide.”

Using information from the Multiple Cause of Death database on all U.S. residents, researchers identified deaths related to IPF and examined annual trends in age-adjusted mortality rates stratified by age, race, sex and residence. Researchers also analyzed trends in place of death and underlying causes of death.

Among men, the age-adjusted mortality per 1 million persons decreased by 4.1%, from 75.5 per 1 million persons in 2004 to 72.4 per 1 million persons in 2017 from 2004 to 2017. Among women, the age-adjusted mortality per 1 million persons decreased by 13.4%, from 46.3 per 1 million persons in 2004 to 40.1 per 1 million persons over the same time period. This decrease was primarily driven by a decline in IPF-related mortality in patients with IPF aged older than 85 years.

Researchers observed a decreasing trend in IPF-related mortality among all races, except white men, in whom the age-adjusted mortality rate remained at a plateau (79 per 1 million persons in 2004 vs. 77.5 per 1 million persons in 2017; P = .44).

The most common cause of death observed was pulmonary fibrosis (67.7%)

In other results, the researchers reported a decrease in deaths occurring in the inpatient setting (49.7% in 2004 vs. 37.1% in 2017; P < .001) and nursing homes (15% in 2004 vs. 12.1% in 2017; P = .001), but an increase in deaths occurring at home (25.5% in 2004 vs. 34% in 2017; P < .001) and in hospice care (0.4% in 2004 vs. 9.2% in 2017; P < .001). Deaths in the outpatient setting, deaths on arrival and deaths occurring in other places remained unchanged.

“Further validation studies are warranted to examine possible factors contributing to this decline in IPF-related mortality,” the researchers wrote. “The increased IPF-related mortality rate in ethnic groups such as Native American people also warrants further investigation into the role of genetic and environmental factors.”