TY - JOUR
T1 - Prognostic Factors in Patients With Pulmonary Hypertension-A Nationwide Cohort Study
AU - Chang, Wei Ting
AU - Weng, Shih Feng
AU - Hsu, Chih Hsin
AU - Shih, Jhih Yuan
AU - Wang, Jhi Joung
AU - Wu, Chun Ying
AU - Chen, Zhih Cherng
N1 - Publisher Copyright:
© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
PY - 2016/9
Y1 - 2016/9
N2 - Background: Pulmonary hypertension (PH) is a rare but fatal condition. Large-scale studies to examine the prognostic factors are lacking. In the present study, we aimed to investigate the factors associated with overall mortality in PH patients. Methods and Results: Based on Taiwan's National Health Insurance Database, we identified 1092 newly identified PH patients between 1999 and 2011. These patients were matched with 8736 healthy subjects based on propensity score calculated with age, sex, and chronic cardiovascular risk factors. Overall mortality, death incidence rate ratio, and hazard ratio were calculated. Patients with PH had a higher mortality than controls (56.45 versus 18.51 per 1000 person-years, P<0.0001), with hazard ratio at 3.3 (95% CI: 2.92-3.73, P<0.001). The long-term survival rates of the PH patients at 1, 5, and 10 years were 87.9%, 72.5%, and 62.6%, respectively, which were significantly lower than controls with 98.4%, 90.8%, and 83.6% at 1, 5, and 10 years, respectively. Among patients with PH, the mortality rate was higher in the older and male patients. However, after stratifying by age and sex, the younger (<50 years) and female patients had a higher risk. Regarding different etiologies of PH, chronic obstructive pulmonary disease and pulmonary embolism led to most cases of mortality (adjusted hazard ratio: 3.2, 95% CI: 2.76-3.71 and 4.64, 95% CI: 2.74-7.87, P<0.05). Conclusions: PH has high mortality, especially in females, and patients with younger age and with chronic diseases. Chronic obstructive pulmonary disease and pulmonary embolism contributed to an increased risk of mortality in PH patients.
AB - Background: Pulmonary hypertension (PH) is a rare but fatal condition. Large-scale studies to examine the prognostic factors are lacking. In the present study, we aimed to investigate the factors associated with overall mortality in PH patients. Methods and Results: Based on Taiwan's National Health Insurance Database, we identified 1092 newly identified PH patients between 1999 and 2011. These patients were matched with 8736 healthy subjects based on propensity score calculated with age, sex, and chronic cardiovascular risk factors. Overall mortality, death incidence rate ratio, and hazard ratio were calculated. Patients with PH had a higher mortality than controls (56.45 versus 18.51 per 1000 person-years, P<0.0001), with hazard ratio at 3.3 (95% CI: 2.92-3.73, P<0.001). The long-term survival rates of the PH patients at 1, 5, and 10 years were 87.9%, 72.5%, and 62.6%, respectively, which were significantly lower than controls with 98.4%, 90.8%, and 83.6% at 1, 5, and 10 years, respectively. Among patients with PH, the mortality rate was higher in the older and male patients. However, after stratifying by age and sex, the younger (<50 years) and female patients had a higher risk. Regarding different etiologies of PH, chronic obstructive pulmonary disease and pulmonary embolism led to most cases of mortality (adjusted hazard ratio: 3.2, 95% CI: 2.76-3.71 and 4.64, 95% CI: 2.74-7.87, P<0.05). Conclusions: PH has high mortality, especially in females, and patients with younger age and with chronic diseases. Chronic obstructive pulmonary disease and pulmonary embolism contributed to an increased risk of mortality in PH patients.
KW - Age
KW - Mortality
KW - Pulmonary hypertension
KW - Sex
UR - http://www.scopus.com/inward/record.url?scp=85030111516&partnerID=8YFLogxK
U2 - 10.1161/JAHA.116.003579
DO - 10.1161/JAHA.116.003579
M3 - Article
C2 - 27572822
AN - SCOPUS:85030111516
SN - 2047-9980
VL - 5
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 9
M1 - e003579
ER -