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. 2021 Jul 6;18(14):7249.
doi: 10.3390/ijerph18147249.

Mortality Associated with Idiopathic Pulmonary Fibrosis in Northeastern Italy, 2008-2020: A Multiple Cause of Death Analysis

Alessandro Marcon  1 , Elena Schievano  2 , Ugo Fedeli  2
Affiliations

Mortality Associated with Idiopathic Pulmonary Fibrosis in Northeastern Italy, 2008-2020: A Multiple Cause of Death Analysis

Alessandro Marcon et al. Int J Environ Res Public Health. .

Abstract

Mortality from idiopathic pulmonary fibrosis (IPF) is increasing in most European countries, but there are no data for Italy. We analysed the registry data from a region in northeastern Italy to assess the trends in IPF-related mortality during 2008-2019, to compare results of underlying vs. multiple cause of death analyses, and to describe the impact of the COVID-19 epidemic in 2020. We identified IPF (ICD-10 code J84.1) among the causes of death registered in 557,932 certificates in the Veneto region. We assessed time trends in annual age-standardized mortality rates by gender and age (40-74, 75-84, and ≥85 years). IPF was the underlying cause of 1310 deaths in the 2251 certificates mentioning IPF. For all age groups combined, the age-standardized mortality rate from IPF identified as the underlying cause of death was close to the European median (males and females: 3.1 and 1.3 per 100,000/year, respectively). During 2008-2019, mortality rates increased in men aged ≥85 years (annual percent change of 6.5%, 95% CI: 2.0, 11.2%), but not among women or for the younger age groups. A 72% excess of IPF-related deaths was registered in March-April 2020 (mortality ratio 1.72, 95% CI: 1.29, 2.24). IPF mortality was increasing among older men in northeastern Italy. The burden of IPF was heavier than assessed by routine statistics, since less than two out of three IPF-related deaths were directly attributed to this condition. COVID-19 was accompanied by a remarkable increase in IPF-related mortality.

Keywords: COVID-19; epidemiology; idiopathic pulmonary fibrosis; mortality; multiple cause of death; time trends analysis; underlying cause of death.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Time trends in age-standardized mortality rates for IPF among males by age class, assessed by UCOD and MCOD analyses. Veneto region, 2008–2019.
Figure 2
Figure 2
Time trends in age-standardized mortality rates for IPF among females by age class, assessed by UCOD and MCOD analyses. Veneto region, 2008–2019.
Figure 3
Figure 3
Number of death certificates with any mention of IPF by month: average count in 2008–2019 and provisional data from the first semester 2020.
See this image and copyright information in PMC

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