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Diffuse Lung Disease |

Delay Timing of Care in a Referral Center and Risk of Death in Idiopathic Pulmonary Fibrosis

Luciana Molinari, MD; Gabriela Tabaj, MD; Maria Otaola, MD; Raquel Aguirre, MD; Silvia Quadrelli*, DrPH
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Buenos Aires British Hospital, Buenos Aires, Argentina


Chest. 2012;142(4_MeetingAbstracts):425A. doi:10.1378/chest.1389064
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Abstract

SESSION TYPE: ILD - Bench to Bedside

PRESENTED ON: Wednesday, October 24, 2012 at 02:45 PM - 04:15 PM

PURPOSE: Idiopathic pulmonary fibrosis (IPF) is often initially misdiagnosed. Recently an association between a longer delay in accessing a tertiary care center and a higher risk of death in IPF has been suggested. In this study we evaluate the relationship between the timing of care in an ILD ( Interstitial Lung Disease) referral center and the risk of death in IPF.

METHODS: We performed a review of all patients with IPF who were seen at the Buenos Aires British Hospital Interstitial Lung Disease Institute between January 2000 and November 2011. Data from the 75 IPF patients with complete data were analyzed. The time of disease was the time from the onset of dyspnea to the initial visit at our tertiary care center (“disease delay”). The time of referral was the time from the initial diagnosis of IPF to the initial visit at our tertiary care center (“referral delay”).

RESULTS: Median survival was not different according to the referral delay times (24,0 vs 8,00 vs 81 months, log-rank 0,083) or the disease delay time (log-rank 0,268). In univariate model neither the referral delay nor the disease delay increased the risk of death.

CONCLUSIONS: Our single-center study did not demonstrate that a longer delay from the onset of dyspnea (disease delay) or from the diagnosis (referral delay) until evaluation at a tertiary care center is associated with a higher rate of death from IPF

CLINICAL IMPLICATIONS: Early access should be facilitated to improve availability of early detection, accuracy of diagnosis, opportunities for participation in clinical trials, rational judgement of indications of ICU admission and the option of lung transplant. However, until effective therapies are identified, the assumption that early referral to a specialty center can improve survival is difficult to sustain.

DISCLOSURE: The following authors have nothing to disclose: Luciana Molinari, Gabriela Tabaj, Maria Otaola, Raquel Aguirre, Silvia Quadrelli

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Buenos Aires British Hospital, Buenos Aires, Argentina

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