Combined idiopathic interstitial pneumonia(IIP) and emphysema(E) in the Veterans Administration(VA) health system: characteristics, tobacco Use, and outcomes

Aims/Objectives: Given the high prevalence of tobacco use, the VA, the largest US healthcare system, is an enriched population for IIP and E. Our objective was to characterize comorbidities, pack year history(PYH), tobacco duration(TY), years between quitting and diagnosis(YQ), diagnosis(Dx) date, supplemental oxygen(02), and deaths among 4 groups:1) IIP with E (IIP+E), 2) IIP without E (IIP-E), 3) lung granuloma(LG) with E (LG+E), and 4) LG without E (LG-E). Methods: Among 3154 patients receiving care for ICD9 515,516 codes at 6 VA centers from 2008-2015, we identified 849 subjects with either IIP or LG(no ILD) based on electronic/manual data extraction and computed tomography. Results: Between IIP+/-E and LG+/-E groups, age at Dx and time from Dx to death were similar. Though the time from Dx to death was similar, the proportion alive 5 yr after Dx was lower in both IIP groups. Mean TY, YQ, and PYH differed among groups. Pulmonary hypertension, diabetes and 02 were more frequent in IIP groups, while lung cancer was greater in the +E groups. Conclusion: In one of the largest reported cohorts of IIP+E, we provide tobacco use data not previously reported and outcomes in a high-prevalence cohort.