Female Patients With ILD Show Lower ICU Mortality Rates: Matthew Viggiano, MD

A recent study explored gender differences in intensive care unit (ICU) outcomes among patients with interstitial lung disease (ILD), highlighting potential variations in disease progression, treatment adherence, and socioeconomic factors, says Matthew Viggiano, MD, internal medicine resident, Temple University Hospital.

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Transcript

Your research showed that female patients with ILD admitted to the ICU had lower mortality and shorter hospital stays. Can you provide an overview of the study and why you chose to investigate this patient subgroup?

At Temple, we're known for the Temple Lung Center, but as a resident at the teaching hospital, we get a lot of exposure to patients with a whole variety of lung pathologies and physiology. My interest has been in pulmonary care, and we see a lot of patients with ILD, both in the clinic setting and the ICU setting, and it kind of raised the question for me and my colleague, Si Li, MD, “What are these patients doing in the ICU? How are they faring in the ICU? How do they fare 1-year out?’ Because we have whole host of modalities to treat these patients. So, we use the NIS, the National inpatient Sample, just as like a slice of America, really, from community hospitals, academic centers, a variety of populations: Latinos, African Americans, Asians, [and] Caucasians, just to see what the studies were between men and women, just because there's new therapies coming out for women vs men. When it comes to antifibrotics, it may be related to estrogen or hormonal therapy. We just thought, “What would this show?” We were pretty surprised by the outcome.

Can you discuss how different socioeconomic factors impact patients with ILD, and could that explain the differences observed in this study?

Anecdotally, in my experience, in working with this population at Temple specifically, the female-male comparison, when it comes to follow-up care just in a primary care setting, there's a noticeable difference. We didn't screen for national data, when it comes to frequency to present for care or follow-up care. In my experience, that's been a noticeable event that happens, day in, day out. The questions that we had were: Men like to smoke more, that's a risk factor for developing some types of interstitial lung disease. Are they showing up to even recognize that they are sick in a timely fashion? Are they parading to present for treatment years in the future where their disease has progressed significantly? Because there are some patterns and physiologies that accelerate in men compared to women. Are they following up? Are they taking their medications? There's a lot of different questions that are not addressed in the study that are more future-direction oriented. Access to care, trust in the health care system, the ability to afford the medications [and] follow-up routinely, from a job standpoint—there's just a lot of questions that we try to triage for the study, but there's so much more to investigate.