{
  "abstract": "Background Pulmonary Fibrosis (PF) describe a group of fibrotic lung diseases which are life-limiting. Despite inclusion in guidelines, only 20% of people with idiopathic pulmonary fibrosis are referred to palliative care services in England. Furthermore, large epidemiological studies on place of death in people with PF are lacking. The aim of this study was to estimate the proportion of people with PF who die in hospital and investigate factors associated with death in hospital.Methods We used data from the Clinical Practice Research Datalink (CPRD) Aurum, linked with Hospital Episode Statistics Admitted Patient Care and Office of National Statistics mortality data to estimate the proportion of people with PF who die in hospital (vs community), and if this had changed over time. Multivariate logistic regression was used to examine factors associated with death in hospital.Results The study population consisted of 13,706 people with at least one record of PF between 1/1/2008 and 31/12/2019. Mean age at death was 79.2 years (SD 9.6), median time between first record of PF to death was 2.5 years (IQR 11.5 months - 5.1 years) and 61.2% were male. The proportion of people with PF dying in hospital decreased from 67.8% in 2008 to 54.0% in 2019, whilst the proportion dying at home increased from 18.6% to 25.6% ( figure 1). Factors associated with death in hospital included male sex (OR 1.12, 95% CI 1.02 – 1.22), younger age at death (OR for 18–69 years 1.58, 95% CI 1.35–1.82), South Asian ethnicity (OR 1.87, 95% CI 1.46–2.39), hospitalization from PF within 30 days of death (OR 4.41, 95% CI 3.85–5.04), comorbid ischaemic heart disease (OR 1.15, 95% CI 1.05–1.25) and heart failure (OR 1.23, 95% 1.10–1.25). Referral to palliative care strongly reduced the likelihood of death in hospital (OR 0.20, 95% 0.18–0.22).Abstract P100 Figure 1Conclusion The proportion of people with PF dying at home has increased, but over half still die in hospital. Proportion of deaths in hospice beds remain unchanged, reflecting capacity and funding restraints. Our findings re-iterate the importance of palliative care in advanced care planning and choice of place in death in these patients.",
  "authors": [
    {
      "affiliations": [
        "Institute for Respiratory Health, University of Western Australia, Perth, Australia",
        "School of Public Health, Imperial College London, London, UK"
      ],
      "name": "V Navaratnam"
    },
    {
      "affiliations": [
        "School of Public Health, Imperial College London, London, UK"
      ],
      "name": "AD Morgan"
    },
    {
      "affiliations": [
        "Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK"
      ],
      "name": "JC Porter"
    },
    {
      "affiliations": [
        "Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK"
      ],
      "name": "R Chambers"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "RG Jenkins"
    },
    {
      "affiliations": [
        "School of Public Health, Imperial College London, London, UK"
      ],
      "name": "JK Quint"
    }
  ],
  "title": "P100 Place of death in people with pulmonary fibrosis: a cohort study using electronic healthcare records in England",
  "uid": "0773463f-1d51-5305-8bc7-608cba2a0b85"
}