Retrospective evaluation of patients diagnosed with idiopathic pulmonary fibrosis between 2015-2020 at Akdeniz University Hospital Chest Diseases Outpatient Clinic

Aim: The aim of this study was to evaluate the demographic, clinical and radiological characteristics of patients diagnosed with interstitial lung disease, as well as diagnosis and treatment approaches and treatment results. Material and Methods: Patients who were diagnosed with 'Diffuse Parenchymal Lung Disease' (ICD 10 code: j84.1) and applied to the Chest Diseases Outpatient Clinic of Akdeniz University Faculty of Medicine between January 01, 2015 and December 31, 2020, were retrospectively scanned through the hospital automation system. Results: The mean age of IPF patients was 67.64±8.22 years, 80.2% (n=134) male, 22.7% farmer (n=29), 4.2% (n =7) family history, 9.0% (n=15) asbestos history, 9.6% (n=16) biomass history, 5.4% (n=6) pet-feeding history, It was determined that 73.3% (n=121) had a comorbidity and 70.8% (n=114) used any medication. While the rate of smokers for 20 pack-years or more was 45.4%, it was determined that 11.46% were still active smokers. The presenting symptoms were cough in 47.9% (n=78) of IPF patients, sputum in 6.1% (n=10), shortness of breath in 54.0% (n=88), 6.1% It was determined that th (n=10) had chest pain. Of the patients who underwent radiological evaluation, 69.2% (n=81) had UIP, 18.2% (n=22) had probable UIP, and 2 patients (1.7%) each had Indeterminate and (1%) ,7) UIP was found to be incompatible. It was determined that 64.5% (n=100) of the patients were diagnosed by a single physician, 14.2% (n=22) by the intra-departmental council, and 20.0% (n=31) by the general council. It was determined that all of the patients (100%) had a clinical and radiological diagnosis, while 30.1% (n=47) had a pathological diagnosis. Pirfenidone was applied to 67.3% (n=105) of the patients, Nintedanib was applied to 24.4% (n=38) of the patients, immunosuppressive drug treatments were applied to 0.6% (n=1) and 7.7% of the patients were treated. It was determined that (n=12) follow-up without treatment was applied. It was determined that 49.1% (n=82) of IPF patients had at least 1 or more side effects, and the most common side effect was skin lesions (30.5%). Side effect rates were found to be similar in the groups receiving pirfenidone and nintedanib (p=0.350). The incidence of skin lesions was higher in those using pirfenidone than in those using nintedanib (p=0.006), and the incidence of diarrhea was higher in those using nintedanib (p<0.001). Switching rates were found to be similar in groups receiving pirfenidone and nintedanib (p>0.05). It was determined that 31.1% (n=51) of the patients were ex, 1-year survival was 79.1%, 3-year survival was 61.9% and 5-year survival was 55.5%. 3-year survival rates were found to be 81.5% in women and 57.1% in men. Survival was 2.4 times higher in women than in men. Although mortality rates were higher in the group receiving nintedanib, the difference was not statistically significant (p>0.05). Conclusion: IPF is a chronic disease associated with progressive fibrosis, and high mortality. Antifibrotic treatment slow disease progression in a broad spectrum of patients and have shown a reduction in mortality in clinical trials. It is thought that our study will be an exemplary research on the IPF patient profile in our country, and there is a need for more extensive research on the subject. Key Words: Diffuse parenchymal lung disease, Idiopathic interstitial pneumonia, Idiopathic pulmonary fibrosis