National trends and inpatient outcomes of pulmonary arterial hypertension related hospitalizations - Analysis of the National Inpatient Sample Database.
Inpatient mortality
National inpatient sample
Pulmonary arterial hypertension
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 11 2020
15 11 2020
Historique:
received:
06
04
2020
revised:
11
06
2020
accepted:
21
06
2020
pubmed:
1
7
2020
medline:
29
4
2021
entrez:
1
7
2020
Statut:
ppublish
Résumé
Pulmonary arterial hypertension (PAH) is associated with a significant burden of morbidity and mortality. We examined national trends in PAH-related hospitalizations, associated inpatient mortality (IM), length of stay (LOS) and hospitalization charges from 2007 to 2016, as well as predictors of IM and LOS in this population. We used the National Inpatient Sample to identify PAH admissions using International classification of diseases (ICD) codes 416.0 (ICD-9) and I27.0 (ICD-10). Records suggestive of secondary causes of pulmonary hypertension were excluded. 6162 (weighted) records with PAH as the primary diagnosis were analyzed. Mean age was 38.7 years, with the majority being females (78.8%). Overall IM was 6.03%, mean LOS 7.6 ± 0.5 days and mean charges $84,100 ± 6200. PAH-related hospitalizations (per million) (27 in 2007 vs. 28 in 2016, p = 0.19) and associated IM (4.5% in 2007 vs. 6.8% in 2016, p = 0.748) as well as LOS (5.9 days in 2007 vs 6.7 days in 2016, p = 0.304) remained unchanged over the decade. Charges increased by 2.4-fold ($43,800 in 2007 to $103,300 in 2016, p = 0.002). While right heart failure, fluid/electrolyte disorders, cardiac arrhythmia and neurological disorders were associated with increased IM, Hispanic race was found to have a survival benefit. Fluid/electrolyte disorders and coagulopathy were associated with increased LOS. Despite significant advancements in PAH therapies over the duration of this study, the rate of PAH hospitalizations, and associated IM and LOS remain unchanged. The study identified the predictors of IM and prolonged LOS in PAH population which could be used for additional risk stratification of these patients.
Sections du résumé
BACKGROUND
Pulmonary arterial hypertension (PAH) is associated with a significant burden of morbidity and mortality. We examined national trends in PAH-related hospitalizations, associated inpatient mortality (IM), length of stay (LOS) and hospitalization charges from 2007 to 2016, as well as predictors of IM and LOS in this population.
METHODS
We used the National Inpatient Sample to identify PAH admissions using International classification of diseases (ICD) codes 416.0 (ICD-9) and I27.0 (ICD-10). Records suggestive of secondary causes of pulmonary hypertension were excluded. 6162 (weighted) records with PAH as the primary diagnosis were analyzed.
RESULTS
Mean age was 38.7 years, with the majority being females (78.8%). Overall IM was 6.03%, mean LOS 7.6 ± 0.5 days and mean charges $84,100 ± 6200. PAH-related hospitalizations (per million) (27 in 2007 vs. 28 in 2016, p = 0.19) and associated IM (4.5% in 2007 vs. 6.8% in 2016, p = 0.748) as well as LOS (5.9 days in 2007 vs 6.7 days in 2016, p = 0.304) remained unchanged over the decade. Charges increased by 2.4-fold ($43,800 in 2007 to $103,300 in 2016, p = 0.002). While right heart failure, fluid/electrolyte disorders, cardiac arrhythmia and neurological disorders were associated with increased IM, Hispanic race was found to have a survival benefit. Fluid/electrolyte disorders and coagulopathy were associated with increased LOS.
CONCLUSION
Despite significant advancements in PAH therapies over the duration of this study, the rate of PAH hospitalizations, and associated IM and LOS remain unchanged. The study identified the predictors of IM and prolonged LOS in PAH population which could be used for additional risk stratification of these patients.
Identifiants
pubmed: 32603739
pii: S0167-5273(20)33414-8
doi: 10.1016/j.ijcard.2020.06.036
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
131-138Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL078946
Pays : United States
Organisme : BLRD VA
ID : I01 BX000369
Pays : United States
Organisme : BLRD VA
ID : I01 BX004426
Pays : United States
Organisme : NHLBI NIH HHS
ID : R21 HL106114
Pays : United States
Organisme : BLRD VA
ID : I01 BX002042
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL134673
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest AC, MK, PC, TT, AR, RLB report no relationships that could be construed as a conflict of interest.