Calendar | For Your Patients | PHA Main Site | Contact Us | About Us | Not a registered user? Sign up here.

Resource Library

Outcomes of Pulmonary Hypertension (PH) patients admitted to a University Hospital MICU

Reviews

  Sign in to add a review

0 comments
Leave a Comment

Conference: 2014 International PHA Conference and Scientific Sessions

Release Date: 06.22.2014

Presentation Type: Abstracts

File Download: 2014 Conference Abstract - Lisa Wheeler

Download Adobe Acrobat

PH is a heterogeneous disorder categorized into 5 groups: 1-pulmonary arterial hypertension; 2-PH due to left heart disease; 3-PH due to lung disease or hypoxia; 4-chronic thromboembolic PH; 5-PH due to multifactorial mechanisms. ICU admission for Group 1 patients portends a poor prognosis; however, it is unknown if a similar short- or long-term risk applies to patients with Group 2-5 PH

Background: PH is a heterogeneous disorder categorized into 5 groups: 1-pulmonary arterial hypertension; 2-PH due to left heart disease; 3-PH due to lung disease or hypoxia; 4-chronic thromboembolic PH; 5-PH due to multifactorial mechanisms. ICU admission for Group 1 patients portends a poor prognosis; however, it is unknown if a similar short- or long-term risk applies to patients with Group 2-5 PH

Methods: Retrospective review of PH patients followed in our Pulmonary Vascular Center admitted to a tertiary care MICU over a 2.5 year period. The number of ICU admissions, ICU mortality and LOS, and mortality after follow-up were compared between the 5 PH groups.  Study data were collected and managed using REDCap electronic data capture tools. Nonparametric methods of statistical analysis were employed.

Results: Of ~450 patients followed at our center, 79 had 122 (mean 1.5/patient) MICU admissions. The overall ICU readmission rate was 32%: 28% (11/40) in Group 1, 25%(2/8) in Group 2, 0% (0/6) in Group 3, 50%(6/12) Group 4, and 46%(6/13) in Group 5. Mean LOS in Group 1 PH patients was 3.0± 3.5d vs 5.1± 5.3 for non-Group 1 (p= 0.03). Overall ICU mortality was 13% (10/79); 15% (6/40) for Group 1 PH vs 10% (4/39) for non-Group 1 patients (p=0.52). Long-term mortality in all groups was high: 40% (16/40) for Group 1 vs 36% (14/39) for non-Group 1 (P=0.82). The cause of death in Group 1 patients, in the ICU or during follow-up, was PH related in 75% versus 0% for Group 2-5 (P= 0.05).

Conclusions: MICU admission portends a poor outcome in PH patients with short-and long-term mortality high in all groups. Group 1 and non-group 1 patients had a similar ICU mortality, although LOS was shorter for Group 1. Death among Group 2-5 patients was not attributable to PH, suggesting the need for careful management of the primary disease.

Type: Clinical Science