Health resource utilisation due to IPF exacerbations in Spain: prospective, observational, multicentric study (OASIS study)

Aims and Objective: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease. The course of IPF includes acute exacerbations (AE-IPF) which lead to a significant decline in lung function and a mortality rate of 85%, with advanced IPF patients at higher risk. This study aims to describe the clinical management of AE-IPF in Spain and their impact on the use of health resources. Methods: Prospective, observational, multicentric real world data study of patient records with confirmed IPF, over 12 months of follow-up in 28 centres. Results: A total of 204 consecutive IPF patients were included: 77% male, average age (SD) 70.8 (7.6) years. Patients were classified by their forced vital capacity (FVC) at baseline (FVC 80% 14.7%). 22 (10.8%) patients suffered 28 AE-IPF (mean (SD): 1.27 (0.63) AE-IPF/patient; mean duration: 16.50 (18.38) days) with higher frequency in patients with advanced IPF: 27.3%, 8.6% and 10.0%, respectively. 75% of the AE-IPF required emergency room visits, 46.4% any specialized care visit and hospitalisation was reported in 75% (mean duration: 8.48 (5.90) days). Management of AE-IPF required X-ray (93.8%), arterial blood gas testing (75%), laboratory tests (57.1%), computed tomography (43.8%) and respiratory virus screening (18.8%). 50% of AE-IPF received pharmacological treatment (32.1% systemic corticosteroids, 7.1% antibiotics for systemic use). Oxygen therapy was needed in 21.4% of AE-IPF. Conclusions: Patients with advanced IPF are at higher risk than those with less advanced disease of suffering AE-IPF, which are associated with a substantial use of health resources.