American Thoracic Society International Conference

American Thoracic Society International Conference

Source:

Goobie GC, et al. Impact of race, ethnicity and social determinants on individuals with lung diseases. Presented at: American Thoracic Society International Conference; May 14-19, 2021 (virtual meeting).

Disclosures: Goobie reports no relevant financial disclosures.
May 16, 2021
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Neighborhood-level disadvantage may impact survival, odds of lung transplant in IPF

Source:

Goobie GC, et al. Impact of race, ethnicity and social determinants on individuals with lung diseases. Presented at: American Thoracic Society International Conference; May 14-19, 2021 (virtual meeting).

Disclosures: Goobie reports no relevant financial disclosures.
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Patients with idiopathic pulmonary fibrosis living in areas with high neighborhood-level disadvantage may have worse survival and lower odds of lung transplantation, researchers reported.

Researchers assessed the impact of neighborhood-level socioeconomic factors on outcomes in patients with IPF using the Area Deprivation Index (ADI) to measure neighborhood-level disadvantage.

Idiopathic pulmonary fibrosis
Source: Adobe Stock.

“Area Deprivation Index has been linked to adverse health outcomes, including increased [hospitalization costs] as well as worse outcomes in stroke and COPD patients,” Gillian C. Goobie, MD, from the Graduate School of Public Health at the University of Pittsburgh, said during a presentation at the American Thoracic Society International Conference. “In our study, we hypothesized that higher neighborhood-level disadvantage, as measured by the Area Deprivation Index, would be associated with increased mortality, reduced baseline lung function and reduced odds of receiving a lung transplant in patients with IPF.”

Goobie and colleagues analyzed consecutive 410 consecutive patients with IPF enrolled in the prospective University of Pittsburgh Simmons Center for Interstitial Lung Disease Registry. Data were collected from March 2000 to January 2020. Using geocoded residential addresses, researchers determined individual ADIs and assessed the impact of ADI on odds of receiving lung transplant and location of death.

One hundred patients with IPF were in the first ADI quartile, which indicates the lowest neighborhood-level disadvantage, 103 were in the second quartile, 104 were in the third quartile and 103 were in the fourth quartile, which indicates the highest neighborhood-level disadvantage.

Researchers observed an association between higher ADI quartile and worse outcomes (HR = 2.1; 95% CI, 1.25-3.52; P = .005) compared with patients with IPF living in the lowest ADI quartile.

The highest ADI quartile was associated with lower odds of a patient with IPF receiving a lung transplant (OR = 0.57; 95% CI, 0.32-0.98; P = .045).

Location of death information was available for 110 patients with IPF. Seventeen percent died at home, 32% died in hospice, 35% died on a hospital floor and 15% died in the ICU.

There was no association between continuous ADI or its quartile and baseline FVC or diffusing capacity for carbon monoxide. In addition, there was no association between ADI and location of death, according to the researchers.

“In the future, we want to investigate the impact of ADI on lung function decline and on other forms of ILD,” Goobie said. “We also aim to look at the interaction between ADI and air pollution in patients with ILD.”

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