Pulmonary arterial hypertension in systemic sclerosis: a national inpatient analysis

被引:2
|
作者
Sami, H. [1 ]
Sami, F. [2 ]
Razok, A. [2 ]
Dasgupta, M. [2 ]
Gajjar, R. [2 ]
机构
[1] Shalamar Med & Dent Coll, Lahore, Pakistan
[2] Cook Cty Hosp, Dept Internal Med, Chicago, IL 60612 USA
来源
ARP RHEUMATOLOGY | 2024年 / 3卷 / 02期
关键词
Pulmonary hypertension; Scleroderma; Systemic sclerosis; Outcome measures; Hospitalized patients; PREVALENCE; SURVIVAL;
D O I
10.63032/JUKW8830
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background:Pulmonary arterial hypertension (PAH) is a progressive, and eventually fatal complication of Systemic Sclerosis (SSc) that affects the prognosis, quality of life, and mortality rate. Non-specific manifestations of PAH can result in delayed diagnosis and therefore in poorer outcomes. Objectives: We aim to study the prevalence and epidemiology of pulmonary arterial hypertension in SSc, and the impact of PAH on SSc hospitalizations in the United States population. Methods: We utilized the National Inpatient Sample (NIS) from 2016-2019 to obtain adult hospitalizations with the primary/secondary diagnosis of SSc and coexistent PAH (SSc-PAH). Epidemiological variables, mortality rates, and secondary outcomes were studied including pulmonary embolism, atrial flutter, atrial and ventricular fibrillation, pneumonia, sepsis, cardiac arrest and cardiac & renal failure, and ventilator requirement. Healthcare burden was estimated from total hospital charges (THC) and length of stay (LOS). Statistical analysis was performed on STATA 16.1, using linear and logistic regression analyses. Results: Out of 126,685 adult systemic sclerosis hospitalizations, 16.89% had PAH (SSc-PAH). The SSc-PAH group had significantly more females (85.4 % vs. 83.8%) and higher mean age (64.85 +/- 13.29 vs. 62.56 +/- 14.51). More African Americans were in this group than in the control group (19.5% vs. 14.6, p-value<0.001) while Whites (61.3% vs. 65.6%, p<0.001) and Asians (18.0 % vs. 2.8%, p<0.001) were less common. Charlson comorbidity index was higher for the SSc-PAH population (3.42 vs. 2.94, p-value<0.001). SSc-PAH group had a higher adjusted odds ratio (aOR) for mortality (aOR: 1.39, p<0.001), increased LOS (6.64 vs. 6.0 days, p<0.001) increased THC ($83,813 vs. $71,016, p <0.001). For the SSc-PAH group, there were also significantly higher odds of cardiac failure (aOR 3.13), ventilator requirement (aOR 2.15), cardiac arrest (aOR 1.39), kidney failure (aOR 1.63), pulmonary embolism (aOR 1.84), atrial flutter (aOR 1.86) atrial fibrillation (aOR1.56) and pneumonia (aOR 1.22). No significant difference in ventricular fibrillation, sepsis, or respiratory failure was noted. Conclusion: Pulmonary arterial hypertension in SSc is associated with worse outcomes in terms of mortality and morbidity, and higher healthcare burden compared to SSc without PAH. Also, PAH disproportionately affects White, African American & Asian populations. There remains a pressing need to continue efforts for early diagnosis and management of PAH in SSc patients.
引用
收藏
页码:95 / 100
页数:6
相关论文
共 50 条
  • [31] PULMONARY ARTERIAL HYPERTENSION IN VERY EARLY SYSTEMIC SCLEROSIS
    Sanchez, J.
    Jordan, S.
    Distler, J.
    Maurer, B.
    Huscher, D.
    Michel, B.
    Speich, R.
    Distler, O.
    ANNALS OF THE RHEUMATIC DISEASES, 2013, 71 : 398 - 398
  • [32] CLINICALSUBTYPE OF PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH SYSTEMIC SCLEROSIS
    Yudkina, Natalia
    Volkov, Alexander
    Nikolaeva, Ekaterina
    Kurmukov, Ildar
    Nasonov, Evgeny
    ANNALS OF THE RHEUMATIC DISEASES, 2019, 78 : 1569 - 1570
  • [33] CAPILLAROSCOPY IN SYSTEMIC SCLEROSIS RELATED PULMONARY ARTERIAL HYPERTENSION
    Smith, Vanessa
    Vanhaecke, Amber
    Guerra, Miguel
    Ruaro, Barbara
    Sulli, Alberto
    Vandecasteele, Els
    Cutolo, Maurizio
    ANNALS OF THE RHEUMATIC DISEASES, 2019, 78 : 854 - 855
  • [34] Integrative Analysis of the Role of Systemic Sclerosis in the Gene Expression of Pulmonary Arterial Hypertension
    Huang, Y.
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2021, 203 (09)
  • [35] Screening for pulmonary arterial hypertension in patients with systemic sclerosis in the era of new pulmonary arterial hypertension definitions
    Erdogan, M.
    Avci, B. Kilickiran
    Ebren, C.
    Ersoy, Y.
    Ongen, Z.
    Ongen, G.
    Hamuryudan, V.
    Hatemi, G.
    CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 2024, 42 (08) : 1590 - 1597
  • [36] Outcome measures in pulmonary arterial hypertension associated with systemic sclerosis
    Kowal-Bielecka, O.
    Delcroix, M.
    Vonk-Noordegraaf, A.
    Hoeper, M. M.
    Naeije, R.
    RHEUMATOLOGY, 2008, 47 : V39 - V41
  • [37] Bosentan treatment in pulmonary arterial hypertension secondary to systemic sclerosis
    Piludu, G.
    Nalli, E.
    Amoresano, D.
    Farci, M.
    Muttini, T.
    D'Aietti, I
    Mura, N.
    Loddo, M.
    Giacco, G.
    ALLERGY, 2008, 63 : 353 - 353
  • [38] Pulmonary arterial hypertension associated with systemic sclerosis in the Czech Republic
    Jansa, Pavel
    Becvar, Radim
    Ambroz, David
    Palecek, Tomas
    Tomcik, Michal
    Skacelova, Simona
    Aschermann, Michael
    Linhart, Ales
    CLINICAL RHEUMATOLOGY, 2012, 31 (03) : 557 - 561
  • [39] CAPILLAROSCOPIC PATTERN IN SYSTEMIC SCLEROSIS WITH/WITHOUT PULMONARY ARTERIAL HYPERTENSION
    Duenas Zambrano, Maria Alejandra
    Lugo Zamudio, Gustavo Esteban
    Maya Pina, Lucia Veronica
    Barbosa Cobos, Rosa Elda
    Coello Vasquez, Victor Hernan Gomez
    JCR-JOURNAL OF CLINICAL RHEUMATOLOGY, 2021, 27 : S118 - S119
  • [40] Refining Risk Prediction in Systemic Sclerosis Pulmonary Arterial Hypertension
    Osgueritchian, Ryan
    Mombeini, Hoda
    Jani, Vivek
    Gami, Abhishek
    Hsu, Steven
    Hummers, Laura
    Wigley, Fredrick
    Lammi, Matthew
    Hassoun, Paul
    Shah, Ami
    Mathai, Stephen
    Mukherjee, Monica
    CIRCULATION, 2024, 150