Conference: 2018 PHA International PH Conference & Scientific Sessions
Release Date: 06.28.2018
Presentation Type: Abstracts
File Download: Conference 2018_1026
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Abstract presented at the 2018 International PH Conference and Scientific Sessions in Orlando, Fla., June 28-July 1, 2018.
Limited contemporary data exists describing hospitalization characteristics for patients with pulmonary hypertension.
Using ICD-9 CM codes in nationwide inpatient sample databases 2003 to 2014, all adult hospitalizations (age > 18 years) with a diagnosis of pulmonary hypertension were identified. Using univariate analyses, we studied hospitalization characteristics, reasons for admissions, co-existing comorbidities, procedures utilized and in-hospital mortality in these hospitalizations.
We identified 1,743,839 hospitalizations with a co-existing diagnosis of pulmonary hypertension with mean age-71.2 + 14.8 years, 60.2% females, 63.0% whites and 81.9% with public insurance. Top primary diagnoses in these hospitalizations were – heart failure (19.7%), COPD (6.3%), pneumonia (5.4%), acute respiratory failure (5.4%) and cardiac dysrhythmias (5.1%). Most common co-existing diagnosis were heart failure (60.7%), cardiac dysrhythmias (47.5%), coronary artery disease (41.4%), COPD (37.8%), valvular heart disease (37.3%), hypertension (37.2%), dyslipidemia (34.4%), chronic kidney disease (27.0%) and diabetes (26.2%). Most common procedures performed were: diagnostic heart catheterization (19.1%), mechanical ventilation (13.0%), blood transfusions (9.0%), heart-valve procedures (5.8%), hemodialysis (5.4%) and echocardiogram (5.0%). From 2003 to 2014, there was a significant decrease in hospitalizations with cardiovascular causes (51.2% to 43.8%) and pulmonary causes (24.8% to 18.9%) (all ptrend<0.001). There was a decrease in proportions of patients with primary diagnosis of congestive heart failure (22.2% to 19.4%), pneumonia (6.6% to 4.7%), COPD (8.8% to 4.6%), while increased for acute respiratory failure (4.7% to 5.5%), cardiac dysrhythmias (4.5% to 4.8%), septicemia (0.9% to 6.9%), acute kidney injury (1% to 2.6%) and chronic kidney disease (1.4% to 2.0%) (all ptrend<0.001). In-hospital mortality for patients with primary diagnosis of cardiovascular (4.1% to 3.8%) and pulmonary cause decreased (7.2% to 6.1%) while significantly increased for those with non-cardiopulmonary diagnosis (4.9% to 5.9%).
Cardiovascular and pulmonary causes were the main reason for admissions and in-hospital mortality has significantly decreased for both of these categories. Interestingly, pulmonary hypertension patients are increasingly being admitted for non-cardiopulmonary causes and there is an urgent need for research and better inter-disciplinary clinical care to improve the mortality and morbidity of pulmonary hypertension patients.