Interstitial lung disease (ILD) is a heterogeneous group of mainly chronic lung diseases differing in disease course and prognosis. For most subtypes, evidence on relevance and outcomes of hospitalisations is lacking. Using German claims data we investigated number of hospitalisations (zero-inflated-negative-binomial models providing rate ratios (RR)) and time to first hospitalisation (Cox proportional-hazard models providing hazard ratios (RR)) for nine ILD-subtypes. Models were stratified by ILD-related and non-ILD-related hospitalisations. We adjusted for age, gender, ILD-subtype, ILD-relevant comorbidities and ILD-medication (immunosuppressive drugs, steroids, anti-fibrotic drugs). Among 36,816 ILD-patients (mean age 64.7 years, 56.2% male, mean observation period 9.3 quarters), 71.2% had non-ILD-related and 56.6% ILD-related hospitalisations. We observed more and earlier non-ILD-related hospitalisations in ILD patients other than sarcoidosis. Medical ILD-treatment was associated with increased frequency and in case of late initiation, earlier (non-)ILD-related hospitalisations. Comorbidities were associated with generally increased hospitalisation frequency except for COPD (RR = 0.90) and PH (RR = 0.94) in non-ILD-related and for lung cancer in ILD-related hospitalisations (RR = 0.89). Coronary heart disease was linked with earlier (ILD-related: HR = 1.17, non-ILD-related HR = 1.19), but most other conditions with delayed hospitalisations. Hospitalisations are frequent across all ILD-subtypes. The hospitalisation risk might be reduced independently of the subtype by improved management of comorbidities and improved pharmacological and non-pharmacological ILD therapy.

中文翻译：

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根据合并症和药物治疗，间质性肺病患者的住院模式–德国索赔数据分析

间质性肺病（ILD）是异质性组，主要是慢性肺部疾病，病程和预后不同。对于大多数亚型，缺乏有关住院治疗的相关性和结果的证据。使用德国的索赔数据，我们调查了9种ILD亚型的住院次数（零膨胀负二项式模型，提供比率（RR））和首次住院时间（Cox比例风险模型提供了危险比（RR））。模型按ILD相关住院和非ILD相关住院分类。我们针对年龄，性别，ILD亚型，与ILD相关的合并症和ILD药物（免疫抑制药物，类固醇，抗纤维化药物）进行了调整。在36,816名ILD患者中（平均年龄64.7岁，男性为56.2％，平均观察期为9.3个季度），其中71.2％的患者与非ILD相关，而ILD相关的住院率为56.6％。我们观察到结节病以外的ILD患者中越来越多的非ILD相关住院治疗。药物性ILD治疗与发病率增加相关，如果是晚期起病，则应提前（非）ILD相关住院治疗。合并症与一般住院率增加相关，除了非ILD相关住院患者的COPD（RR = 0.90）和PH（RR = 0.94）以及ILD相关住院患者的肺癌（RR = 0.89）。冠心病与早期疾病有关（ILD相关：HR = 1.17，非ILD相关HR = 1.19），但大多数其他情况与住院时间延迟有关。所有ILD亚型的住院治疗都很频繁。通过改善合并症的管理以及药理学和非药理学的ILD治疗，可以降低住院风险，而与亚型无关。