Patients with IPF who experience in-hospital cardiac arrest face increased mortality rate
NASHVILLE, Tenn. — Idiopathic pulmonary fibrosis appeared associated with increased mortality rates and worse outcomes among in-hospital cardiac arrest survivors, according to study results presented at the CHEST Annual Meeting.
“We know that in-hospital cardiac arrest is a major event that can have major mortality and morbidity in any hospitalization. So, we were looking at the prognosis in patients with idiopathic pulmonary fibrosis in terms of in-hospital cardiac arrest,” Majd Fayad Nimer Al-Ahmad, MBBS, geriatric fellow at the University of Pittsburgh, said during his presentation. “We don’t find a lot of studies regarding that, and the prognosis was unclear.”
Researchers used 2016 to 2019 data from the National Inpatient Sample Database to analyze 794,119 patients with IPF who survived in-hospital cardiac arrest and received cardiopulmonary resuscitation with or without a secondary IPF diagnosis. Researchers adjusted for age, gender, race, Charlson Comorbidity Index, hospital type and size, hospital region and hospital teaching status.
Mortality risk and odds of palliative care served as the study’s primary outcomes. Secondary outcomes included in-hospital complications, hospital length of stay and total health care costs during hospitalization.
Overall, 8,670 patients (mean age, 65 years; 57% men) had an IPF diagnosis with a mean hospital length of stay of 9.1 days and total health care costs of $168,628.
Patients with IPF experienced higher odds for mortality (OR = 2.14; 95% CI, 1.89-2.4) and palliative care (OR = 1.25; 95% CI, 1.12-1.4). In addition, researchers also observed higher odds of tracheostomy (OR = 1.6; 95% CI, 1.16-2.2), pneumonia (OR = 2.13; 95% CI, 1.97-2.37) and pneumothorax (OR = 2.04; 95% CI, 1.63-2.54).
According to Al-Ahmad, it was not surprising to also note prolonged hospital length of stay (1.83 more days) and higher health care costs ($31,662) among this patient population as more complications lead to extended hospital stays and more money spent.
“It is important to include this in our discussion surrounding goals of care and status of these patients,” Al-Ahmad said. “But probably we can include palliative care services earlier to decrease the burden on patients, their families and the health care system.”