Dr Cesar Davila-Chapa Calls for Awareness of Racial Differences in IPF Hospitalization

Findings presented at the CHEST 2024 annual meeting last week in Boston, Massachusetts, showed racial differences in outcomes among patients hospitalized with idiopathic pulmonary fibrosis (IPF). Using data from the National Inpatient Sample (NIS; 2016-2019), researchers analyzed 14,815 hospitalizations, where 9.15% of patients were Black and 90.85% were non-Hispanic White.

Key findings included:

• Demographic Disparities: Black patients hospitalized with IPF were significantly younger (mean age 63.67 vs 72.02 years) and more likely to be female (64.9% vs 36.8%) compared with White patients.
• Hospitalization and Mortality: The length of hospital stays was similar between Black and White patients (~9 days), but inpatient mortality was higher among White patients (11.6% vs 7.4%).
• Potential Underdiagnosis: Black patients were less likely to be hospitalized with IPF, possibly due to underdiagnosis or misclassification in coding.
• Better Survival in Black Patients: Despite younger age at admission, Black patients had better inpatient survival outcomes.

In an interview with The American Journal of Managed Care^® (AJMC^®), lead investigator Cesar Davila-Chapa, MD, pulmonary and critical care cochief fellow at the University of Nebraska Medical Center, emphasized that racial disparities persist in IPF hospitalizations and outcomes, underscoring the need for further research to confirm these findings and address inequities in care.

This transcript has been lightly edited for clarity.

Transcript

Can you share the motivation and key findings of the research you presented at CHEST?

We know that racial and ethnic disparities exist, and I wanted to kind of raise awareness as well as see what existence there is, and mostly within hospitalizations of those patients with IPF. In my study, we reviewed the [National Inpatient Sample] database and found many hospitalizations. We wanted to see what the outcomes were in these hospitalizations and what age the patients were first admitted at. And we found that there are disparities that exist in the health care system.

We found that Black patients are admitted at a younger age and non-Hispanic White patients at a later age. There could be many implications that we don't know, specifically at this time, what these implications mean. But it is a mimic of other studies, reinforcing and raising more awareness that there are disparities that exist, and it shows that patients may be sicker at an earlier age. And we are more aware of this because although the study did show that there was a decreased mortality in Black patients versus non-Hispanic White patients, that's only during hospitalizations. We don't know what happens in the outpatient setting. So that's important to know that they're presenting at a younger age.

There was a more pertinent [finding] in terms of there being more female Black patients versus female White patients. That could mean other implications as well. We think it's important to raise awareness to kind of prevent these disparities. And how do we do that? You know, we need to first be aware of what disparities exist.

I think studies like this, whether they're database studies—and they do have limitations—I think it's still important to raise awareness. So that we can move on to the next step with prospective studies, with steps to push our boundaries and push where health care is now and to provide better care and be aware that maybe Black patients can be diagnosed with IPF at a younger age. And that is something to raise awareness in terms of putting in our differential as pulmonary physicians.

Reference

Davila-Chapa C, Thotamgari SR, Chaaban S. Racial differences in hospitalizations for idiopathic pulmonary fibrosis in the United States. CHEST. 2024;166(4):A3814.