University of Oulu

Kärkkäinen, M., Nurmi, H., Kettunen, H., Selander, T., Purokivi, M., Kaarteenaho, R. (2018) Underlying and immediate causes of death in patients with idiopathic pulmonary fibrosis. BMC Pulmonary Medicine, 18 (1), 69. doi:10.1186/s12890-018-0642-4

Underlying and immediate causes of death in patients with idiopathic pulmonary fibrosis

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Author: Kärkkäinen, Miia1,2,3; Nurmi, Hanna1,4; Kettunen, Hannu-Pekka5;
Organizations: 1Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland
2Kuopio City Home Care, Rehabilitation and Medical Services for Elderly
3Kuopio University Hospital and University of Eastern Finland
4Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital
5Department of Clinical Radiology, Kuopio University Hospital
6Science Services Center, Kuopio University Hospital
7Respiratory Medicine, Research Unit of Internal Medicine, University of Oulu and Medical Research Center Oulu, Oulu University Hospital
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2018080933591
Language: English
Published: Springer Nature, 2018
Publish Date: 2018-08-09
Description:

Abstract

Background: The most common cause of death of patients with idiopathic pulmonary fibrosis (IPF) has been reported to be the lung disease itself and mortality from IPF appears to be increasing. However, the causes of death in patients with IPF taking into account differences between genders and smoking histories as well as disease progression, have not been previously explored.

Methods: Retrospective data from hospital register and death certificates from national database of IPF patients treated in Kuopio University Hospital (KUH) from 2002 to 2012 were collected. Mortality was also explored from the death registry database via ICD-10 code J84 revealing the numbers of deaths from pulmonary fibrosis in Finland from 1998 to 2015.

Results: Out of 117 deaths, 26.5% were females and 73.5% males in KUH. The most common underlying causes of death were IPF 67.5% and ischemic heart diseases 14.8%. More males died for reasons other than IPF (39.5%) compared to females (12.9%) (p = 0.007). Pneumonia as the immediate cause of death was more common in males (27.9%) than in females (3.2%) (p = 0.004) and in ex-smokers (32.7%) compared to non-smokers (9.3%) (p = 0.007). Death register based mortality from pulmonary fibrosis is increasing in Finland.

Conclusions: Even though the overall mortality was higher in males with IPF, the disease-specific mortality for IPF was higher in females i.e. in males, comorbidities were more often the underlying causes of death. Pneumonia-triggered acute exacerbations of IPF may be associated with smoking and gender since females and non-smokers were less likely to succumb to pneumonia. We conclude that disease progression at the end of life may vary depending on smoking habits and gender.

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Series: BMC pulmonary medicine
ISSN: 1471-2466
ISSN-E: 1471-2466
ISSN-L: 1471-2466
Volume: 18
Article number: 69
DOI: 10.1186/s12890-018-0642-4
OADOI: https://oadoi.org/10.1186/s12890-018-0642-4
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 Internal medicine
Subjects:
Funding: M. K. Has received grants for scientific work from the Foundation of the Finnish Anti-Tuberculosis Association, the Organization for Respiratory Health in Finland, Väinö and Laina Kivi Foundation, the Kuopio region respiratory foundation and Jalmari and Rauha Ahokas foundation; H.N. Has received grants for scientific work from the Foundation of the Finnish Anti-Tuberculosis Association, the Organization for Respiratory Health in Finland, Väinö and Laina Kivi Foundation, the North Savo Regional Fund of the Finnish Cultural Foundation, the Kuopio region respiratory foundation, Jalmari and Rauha Ahokas foundation and the state subsidy of the Kuopio University Hospital; M.P. Received grants for scientific work from research director of Kuopio University Hospital, Foundation of the Finnish Anti-Tuberculosis Association, the Kuopio region respiratory foundation and the Jalmari and Rauha Ahokas foundation; R. K. Has received grants for scientific work and for the research team from the state subsidy of Kuopio University Hospital, the Foundation of the Finnish Anti-Tuberculosis Association and the Kuopio Region Respiratory Foundation.
Copyright information: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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