Respiratory medicine and research · 2026
Real-world evidence on hospitalization, infection, and vascular outcomes among interstitial lung disease subtypes.
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Chao Wen-Cheng, Liao Shu-Yi
Аннотация
BACKGROUND AND OBJECTIVE: Interstitial lung diseases (ILDs) consist of idiopathic pulmonary fibrosis (IPF) and non-IPF ILDs. While pulmonary complications in IPF are relatively well-studied, there is a need for research on non-IPF ILDs, including connective tissue disease-associated ILDs (CTD-ILDs), and non-pulmonary outcomes of ILDs. We compare hospitalization, infection, and pulmonary/cardiac vascular event outcomes in patients with various ILDs.
METHODS: We used data from 82 healthcare organizations between 2014 and 2023 on the TriNetX Research Network. In addition to IPF, we included patients with rheumatoid arthritis (RA)-ILD, systemic sclerosis (SSc)-ILD, myositis-ILD, hypersensitivity pneumonitis (HP) and pulmonary sarcoidosis. We employed propensity score matching (PSM) and assessed outcomes, including hospitalization, infection, and pulmonary/cardiac vascular events within one year of diagnosis.
RESULTS: A total of 66,771 patients met the inclusion criteria, with 15,228 diagnosed with IPF and 51,543 with non-IPF ILDs. Anti-fibrotic agents were used in 30.4% of IPF patients. IPF patients had higher risks of hospitalization, cytomegalovirus disease, aspergillosis, and pulmonary/cardiac vascular event compared to those with non-IPF ILDs. Within CTD-ILDs, RA-ILD was associated with increased risks of sepsis, bacteremia, and pneumonia, while SSc-ILD had higher risks of pulmonary vascular events. Myositis-ILD showed elevated risks of hospitalization and mortality compared to RA-ILD, whereas patients with HP and pulmonary sarcoidosis experienced more favorable outcomes.
CONCLUSIONS: We identified distinct risk profiles across ILD subtypes, with increased infection risks in RA-ILD and heightened pulmonary/cardiac vascular event risks in SSc-ILD and IPF. These findings emphasize the need for targeted surveillance/management strategies for different ILD subtypes.
METHODS: We used data from 82 healthcare organizations between 2014 and 2023 on the TriNetX Research Network. In addition to IPF, we included patients with rheumatoid arthritis (RA)-ILD, systemic sclerosis (SSc)-ILD, myositis-ILD, hypersensitivity pneumonitis (HP) and pulmonary sarcoidosis. We employed propensity score matching (PSM) and assessed outcomes, including hospitalization, infection, and pulmonary/cardiac vascular events within one year of diagnosis.
RESULTS: A total of 66,771 patients met the inclusion criteria, with 15,228 diagnosed with IPF and 51,543 with non-IPF ILDs. Anti-fibrotic agents were used in 30.4% of IPF patients. IPF patients had higher risks of hospitalization, cytomegalovirus disease, aspergillosis, and pulmonary/cardiac vascular event compared to those with non-IPF ILDs. Within CTD-ILDs, RA-ILD was associated with increased risks of sepsis, bacteremia, and pneumonia, while SSc-ILD had higher risks of pulmonary vascular events. Myositis-ILD showed elevated risks of hospitalization and mortality compared to RA-ILD, whereas patients with HP and pulmonary sarcoidosis experienced more favorable outcomes.
CONCLUSIONS: We identified distinct risk profiles across ILD subtypes, with increased infection risks in RA-ILD and heightened pulmonary/cardiac vascular event risks in SSc-ILD and IPF. These findings emphasize the need for targeted surveillance/management strategies for different ILD subtypes.