Mechanical ventilation in idiopathic pulmonary fibrosis patients in Korea: A nationwide population-based study

초록

Background and Aims The prognosis of idiopathic pulmonary fibrosis (IPF) patients with respiratory failure requiring mechanical ventilation is known to be dismal. International guideline suggests not to use mechanical ventilation in majority of IPF patients. However, it is reported that the outcome of mechanically ventilated patients, even IPF patients, has improved. We investigated the use of mechanical ventilation in IPF patients and their outcome according to time in Korea. Methods Using National Health Insurance Service database,we identified IPF patients from 2011 to 2019. We investigated annual number of IPF patients treated with mechanical ventilation and their mortality of each year. We analyzed the change in mortality over time using Cochran-Armitage test. Results During study period, total 1227 patients were mechanically ventilated. The annual number of IPF patients and IPF patients with mechanical ventilation has increased over time, but the ratio was relatively stable around 3.5%. During study period, the overall 30-day mortality of IPF patients with mechanical ventilation was 68.7%. The annual 30-day mortality has not improved over time (p=0.821). The overall 90-day mortality was 85.3%, and the annual 90-day mortality has improved over time (p=0.028). Conclusion The 30-day mortality has not improved in recent years, but it was better than previous reports. The 90-day mortality was still high, but it has improved over time.