• Ilaria Bassi, Stefania Pastorello, Aldo Guerrieri, Gilda Giancotti, Anna Maria Cuomo, Chiara Rizzelli, Maria Coppola, Danila Valenti, and Stefano Nava.
• Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.
• Eur. J. Intern. Med. 2024 Oct 1; 128: 818681-86.

BackgroundIdiopathic Pulmonary Fibrosis (IPF) is a lethal disease; most patients die in hospitals because palliative care (PC) is not wildly and early available. We aimed to determine the impact of an early PC program in IPF patients on place of death, emergency department (ED) admission, unplanned medical visits and survival before and after its implementation at our clinic.MethodsIPF patients from our ILD clinic who died between January 1st, 2018 and December 31th, 2023 were included in the analysis. Primary outcomes were location of death, number of ED access and unplanned medical visits; secondary outcomes was survival from diagnosis.ResultsA total of 46 decedents between 2018 and 2023 were analysed: (median age 71,5 ± 5,5 years, 89 % male): 26 died before the implementation of the early PC program and 20 after. Through χ2 test, location of death resulted significantly different in the two groups, showing the capacity of early PC to favor at home or in hospice death (p = 0,02); similarly, the number of unplanned visits was significantly lower (p = 0,03). Finally, survival was significantly lower in patients not receiving the early PC program (p = 0,01).ConclusionThe availability of an early PC program since the diagnosis significantly reduced both the death rate in hospital settings, favoring dying in hospice or at home, and the number of unplanned medical visits. Furthermore, IPF patients receiving early PC showed a longer survival than those who did not.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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