Hospitalisations in patients with idiopathic pulmonary fibrosis: insights from the IPF-PRO Registry and EMPIRE Registry

Background We used data from the European MultiPartner IPF Registry (EMPIRE) and the US Idiopathic Pulmonary Fibrosis-PRospective Outcomes (IPF-PRO) Registry to examine the frequency of hospitalisation, risk factors associated with hospitalisation, and whether hospitalisation affected 5-year mortality in patients with IPF. Methods Data from January 2015 to September 2022 in EMPIRE and from June 2014 to December 2023 in the IPF-PRO Registry were analysed. Rates of hospitalisation and death were estimated using the Kaplan–Meier method. Associations between patient characteristics at enrolment and time to hospitalisation were assessed using Cox regression. Results The EMPIRE and IPF-PRO Registry cohorts comprised 2989 and 1001 patients, respectively. Median follow-up was 36.5 months in EMPIRE and 60 months in the IPF-PRO Registry. Overall, 20.3% of patients in EMPIRE and 70.3% (28.2% over 36 months) in the IPF-PRO Registry had ≥1 hospitalisation during follow-up. In both registries, lower diffusing capacity of the lungs for carbon monoxide (DLco) % predicted and use of supplemental oxygen at enrolment were associated with an increased risk of hospitalisation in multivariable models. Five-year mortality did not differ between patients who were and were not hospitalised in EMPIRE (54.3% and 53.7%, respectively) or in the IPF-PRO Registry (51.7% and 46.1%, respectively). Conclusions Data from EMPIRE and the IPF-PRO Registry demonstrate the high risk of hospitalisations and mortality among patients with IPF and suggest there may be differences across countries in risk of hospitalisation. Variability in data collection, healthcare systems and clinical practices should be considered when interpreting differences between countries.