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Multicenter Study
. 2021 Mar 18;16(3):e0247316.
doi: 10.1371/journal.pone.0247316. eCollection 2021.

Interstitial lung disease in a veterans affairs regional network; a retrospective cohort study

Armando Bedoya  1 , Roy A Pleasants  2 , Joel C Boggan  1   3 , Danielle Seaman  4 , Anne Reihman  1 , Lauren Howard  5 , Robert Kundich  3 , Karen Welty-Wolf  1   3 , Robert M Tighe  1   3
Affiliations
Multicenter Study

Interstitial lung disease in a veterans affairs regional network; a retrospective cohort study

Armando Bedoya et al. PLoS One. .

Abstract

Background: The epidemiology of Interstitial Lung Diseases (ILD) in the Veterans Health Administration (VHA) is presently unknown.

Research question: Describe the incidence/prevalence, clinical characteristics, and outcomes of ILD patients within the Veteran's Administration Mid-Atlantic Health Care Network (VISN6).

Study design and methods: A multi-center retrospective cohort study was performed of veterans receiving hospital or outpatient ILD care from January 1, 2008 to December 31st, 2015 in six VISN6 facilities. Patients were identified by at least one visit encounter with a 515, 516, or other ILD ICD-9 code. Demographic and clinical characteristics were summarized using median, 25th and 75th percentile for continuous variables and count/percentage for categorical variables. Characteristics and incidence/prevalence rates were summarized, and stratified by ILD ICD-9 code. Kaplan Meier curves were generated to define overall survival.

Results: 3293 subjects met the inclusion criteria. 879 subjects (26%) had no evidence of ILD following manual medical record review. Overall estimated prevalence in verified ILD subjects was 256 per 100,000 people with a mean incidence across the years of 70 per 100,000 person-years (0.07%). The prevalence and mean incidence when focusing on people with an ILD diagnostic code who had a HRCT scan or a bronchoscopic or surgical lung biopsy was 237 per 100,000 people (0.237%) and 63 per 100,000 person-years respectively (0.063%). The median survival was 76.9 months for 515 codes, 103.4 months for 516 codes, and 83.6 months for 516.31.

Interpretation: This retrospective cohort study defines high ILD incidence/prevalence within the VA. Therefore, ILD is an important VA health concern.

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Conflict of interest statement

Dr. Tighe discloses that he has received funding from the NIH and industry to perform research studies unrelated to the present study. Dr. Tighe also has served on an advisory board for Boehringer Ingelheim. None of the other authors have any conflicts of interest to report for the submitted work. These disclosures do not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Kaplan Meier survival based on ICD-9 code.
Information obtained from electronic medical record review was used to define survival for all-cause mortality.
See this image and copyright information in PMC

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