{
  "abstract": "Background Social deprivation impacts chronic disease and acute admission outcomes. In interstitial lung disease (ILD), prior British Thoracic Society registry data for idiopathic pulmonary fibrosis have shown high deprivation was associated with poorer long-term outcomes. However, its impact on acute admissions in ILD is not known.Methods We undertook a multicentre, retrospective study of ILD-related admissions between 1 January 2017 and 31 December 2019 across 11 hospitals in the North West of England, using available real-world data. We determined social deprivation geographically by the 2019 English Indices of Deprivation deciles. The primary outcome was 90-day all-cause mortality.Results 999 admissions met the inclusion criteria. 327/999 (32.7%) of admissions came from individuals geographically in the most deprived 20%. Across 999 admissions, in unadjusted survival analysis, we observed a non-linear relationship between deprivation and 90-day all-cause mortality. In complete case multivariate modelling, deprivation demonstrated borderline significant association with all-cause mortality (HR 1.038, 95% CI 1.00 to 1.077, p=0.050). However, this effect was lost in pooled analysis using multiple imputation (HR 1.001, 95% CI 0.971 to 1.033, p=0.924). Male sex and pre-admission long-term oxygen were consistently associated with increased 90-day all-cause mortality across both models. Lower transfer factor for carbon monoxide values were significantly associated with increased 90-day mortality in pooled analysis.Conclusion We observe a high burden of acute ILD-related hospital admission among the most deprived 20%, suggesting geographical deprivation may impact acute healthcare seeking behaviours. Once admitted, the impact of deprivation appears more complex and multifactorial. Further studies which assess geographical and individual-level deprivation are needed to validate our findings.",
  "authors": [
    {
      "affiliations": [
        "Lancaster Medical School, Lancaster University, Lancaster, England, UK",
        "Respiratory Medicine, University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal, England, UK"
      ],
      "name": "Laura J White"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Stockport NHS Foundation Trust, Stockport, UK"
      ],
      "name": "Jonathon Shaw"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK"
      ],
      "name": "Bethan Powell"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Northern Care Alliance NHS Foundation Trust, Salford, England, UK"
      ],
      "name": "Nyan M Kyi"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Northern Care Alliance NHS Foundation Trust, Salford, England, UK"
      ],
      "name": "Alicia Sou"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Bolton NHS Foundation Trust, Bolton, UK",
        "Division of Infection, Immunity & Respiratory Medicine, The University of Manchester, Manchester, UK",
        "School of Health, Science and Society, University of Greater Manchester, Bolton, UK"
      ],
      "name": "Gareth Edward Hughes"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Bolton NHS Foundation Trust, Bolton, UK"
      ],
      "name": "Dilanka Tilakaratne"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Manchester University NHS Foundation Trust, Manchester, England, UK",
        "School of Medical Sciences, The University of Manchester, Manchester, England, UK"
      ],
      "name": "Conal Hayton"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Manchester University NHS Foundation Trust, Manchester, England, UK"
      ],
      "name": "Trishala Raj"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Manchester University NHS Foundation Trust, Manchester, England, UK"
      ],
      "name": "Vi Truong"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Manchester University NHS Foundation Trust, Manchester, England, UK"
      ],
      "name": "Nashwah Ismail"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Manchester University NHS Foundation Trust, Manchester, England, UK"
      ],
      "name": "Nawat Khanijoun"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Rebecca Huang"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Emma Hardy"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Mahzaib Babar"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Naayaab Khan"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Martin Regan"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Oby Okpala"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Ragavilasini Suresh"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Jerome Mcintosh"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Amsal Amjad"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Mahum Sohail"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, England, UK"
      ],
      "name": "Zainab Aslam"
    },
    {
      "affiliations": [
        "Lancaster Medical School, Lancaster University, Lancaster, England, UK"
      ],
      "name": "Amy Gadoud"
    },
    {
      "affiliations": [
        "Lancaster Medical School, Lancaster University, Lancaster, England, UK",
        "Respiratory Medicine, University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal, England, UK",
        "Pears Cumbria School of Medicine, Imperial College London, Carlisle, UK"
      ],
      "name": "Timothy Gatheral"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Northern Care Alliance NHS Foundation Trust, Salford, England, UK"
      ],
      "name": "Georges Ng Man Kwong"
    }
  ],
  "title": "Retrospective analysis of acute admissions for interstitial lung disease suggests a complex, multifactorial association between social deprivation and 90-day all-cause mortality: data from the North West of England",
  "uid": "63f7d2af-90af-5754-abb7-85519a5c938b"
}