Association of Emergency Room Visits with Outcomes in Idiopathic Pulmonary Fibrosis: A Brief Report from the Pulmonary Fibrosis Foundation Registry.

RATIONALE: Emergency Room visits are common in patients with idiopathic pulmonary fibrosis but their association with clinical outcomes is unknown. OBJECTIVES: We sought to determine the association of ER visits not associated with subsequent hospitalization in patients with idiopathic pulmonary fibrosis on transplant-free survival. METHODS: An analysis of the Pulmonary Fibrosis Foundation Patient Registry data was performed. Transplant-free survival was compared between patients with idiopathic pulmonary fibrosis who had (1) no emergency room visits or hospitalizations (2) emergency room visits without a resulting hospitalization and (3) inpatient hospitalization. OUTCOMES: Data from a total of 1226 IPF participants in the PFF Registry followed for a mean of 976. 8 days (SD of 530.9) was analyzed. 416 participants (33.9%) were hospitalized and 103 participants (8.9%) had ER visits that didn't result in hospitalization. Unadjusted Cox regression model found no difference in transplant-free survival between participants with ER visit only (HR 0.78, 95% CI 0.55,1.12) and those with no hospital visit; however, participants with inpatient (IP) hospitalization events did manifest a decreased transplant-free survival (HR 1.40, 95% CI 1.17,1.695) relative to those with no hospital visits. Unadjusted univariate Cox regression analysis comparing respiratory-related ER visits to no hospitalization failed to demonstrate a significant difference in transplant-free survival (HR 1.49, 95% CI 0.88, 2.51). CONCLUSIONS: IPF patients experiencing ER visits not resulting in hospitalization do not appear to be at an increased risk of death or transplantation in comparison to patients not having an ER visit.