Mortality and diagnostic practice variation in interstitial lung disease admissions : insights from a multicentre UK cohort study

White, Laura Jane and Shaw, Jonathon and Powell, Bethan and Kyi, Nyan M and Sou, Alicia and Hughes, Gareth Edward and Tilakaratne, Dilanka and Hayton, Conal and Raj, Trishala and Truong, Vi and Ismail, Nashwah and Khanijoun, Nawat and Huang, Rebecca and Hardy, Emma and Aslam, Zainab and Sohail, Mahum and Babar, Mahzaib and Amjad, Amsal and Khan, Naayaab and Regan, Martin and Okpala, Oby and Suresh, Ragavilasini and Mcintosh, Jerome and Gadoud, Amy and Gatheral, Timothy and Ng Man Kwong, Georges (2026) Mortality and diagnostic practice variation in interstitial lung disease admissions : insights from a multicentre UK cohort study. BMJ open respiratory research, 13 (1): e004017. ISSN 2052-4439

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Abstract

BackgroundInterstitial lung diseases (ILDs) are a heterogeneous group of often progressive, unpredictable diseases. They frequently result in hospitalisations secondary to respiratory decompensation, termed ILD-related admissions. A proportion are due to an acute exacerbation of ILD (AEILD). All are associated with high mortality but are poorly characterised in real-world populations.AimTo evaluate mortality outcomes and associated risk factors following ILD-related hospital admissions, including AEILD.MethodsWe conducted a multicentre retrospective cohort study of primary International Classification of Diseases Version 10 coded admissions for ILD between 1 January 2017 and 31 December 2019 across 11 NHS hospitals in the North West of England. AEILD events were classified using clinical criteria: ResultsOf 938 ILD-related admissions, 54.5% met study AEILD criteria. Overall, cumulative all-cause mortality to 90-days post-discharge was 40.2%. For the AEILD cohort, cumulative all-cause mortality to 90-days post-discharge was 47.6%. Median survival of the AEILD cohort was 107 days (95% CI 87.0 to 141.0 days) and the other ILD-related admission cohort 241.0 days (95% CI 208.0 to 308.0 days), with a statistically significant difference in survival (pConclusionsMortality associated with ILD-related admissions is high, with AEILD events independently associated with mortality. Findings highlight the need for improved education, access to palliative care and targeted AEILD research.