S16 Impact of hospitalisation in ILD subtypes and predictors of outcome

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Background Predicting the clinical course of Interstitial Lung Disease (ILD) remains challenging. Hospitalisations are frequent across all subtypes, altering the trajectory and resulting in significant morbidity and mortality. Outside IPF there is scarce literature regarding the impact of hospitalisation. We aim to further understand the significance of hospital admissions in ILD patients. Methods We undertook a retrospective observational study of all ILD medical admissions between January 2022 and December 2023. The cohort was stratified by ILD subtype, data collection included demographics, admissions investigations (FBP, CRP, Trop, BNP, Neutrophil Lymphocyte Ratio [NLR]), and measures of disease burden at clinic review. Outcome measures included inpatient mortality, length of stay (LOS), readmission within 30 and 90 days and survival. We interrogated the relationship of combinations of admission investigations and ILD characteristics to outcome measures. Results During the study period there were 114 admissions events (86 individual patients). Baseline characteristics per subgroup are presented in table 1. Overall: mean age 76.5 (SD 9.8), 54% male, median Charlestown Comorbidity Index (CCI) 6 (IQR 4.25–7), median GAP score 5 (IQR 3–6), 46% required LTOT, and 19% were treated with anticoagulation pre-admission. Treatment: 82% received antibiotics, 57% received corticosteroids, 19% received diuretics, and 3% received Respiratory Support. Median LOS 6 days (IQR 4–9). The inpatient mortality rate was 8%, with readmission within 30 days 36% and 90 days 52%. The median survival following admission was 7 months, 12% died in the community. IP mortality correlated significantly with admission CRP (r 0.275), there was no relationship with NLR, Trop, BNP, or anticoagulation use. Age (r 0.207) and 6MWT (r -0.438) were significantly correlated with readmission, however CCI was not. LTOT use preadmission was associated with reduced survival (r -0.257) whereas preserved Transfer factor (r 0.257) was associated with survival. Conclusion Predictors of increased healthcare utilisation include age and decreased functional capacity (6MWT) but not comorbidity. Overall, there is a poor prognosis in all ILD subtypes following hospital admission, this may provide a window of opportunity to proactively engage with palliative care services.

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