Hospitalizations in Idiopathic Pulmonary Arterial Hypertension

Abstract

Idiopathic pulmonary arterial hypertension (IPAH) related hospitalizations contribute to morbidity, mortality and incur substantial healthcare costs. Several advances in management have been achieved over the last decade. We compare IPAH hospitalizations from 2007 and 2017 using the Nationwide In-patient Sample (NIS) database.A retrospective, observational, population-based cohort analysis. IPAH was identified using the ICD-9-CM (416.0) and ICD-10-CM codes (I27.0) for 2007 and 2017 respectively. Total hospitalizations, demographics, primary payer, bed size, region, all-cause mortality, median length of stay, and median charges were analyzed.IPAH diagnosis was associated with 0.05% of all hospitalizations in 2007 and 0.03% in 2017 with most being at large-bed hospitals. Hospitalizations occurred mostly in females compared to males (11,542 (65.2%) in 2007 vs. 6380 (68.4%) in 2017), but males carried a higher mortality. White patients accounted for 9349/17,713 (67.4%) of all hospitalizations for IPAH in 2007 and 5755/9,330 (64.1%) in 2017 accounting for the most frequently hospitalized patient race for IPAH during both time points. Regional variations were also noted with unequal distribution of hospitalizations across the US. Medicare was the primary payer in most admissions in both years (11,931 (67.4%) in 2007 vs 5795 (62.3%) in 2017). Total all-cause mortality (IPAH Hospitalization) decreased in 2017 (4.8%) compared to 2007 (6.4%) (p<0.001). Total charges in United States Dollars (USD) increased substantially from 2007 to 2017 ($26,016 vs. $46,450) but decreased when compared to overall hospitalization cost.Over the decade evaluated, there have been significant reductions in IPAH related hospitalizations, reduced all-cause mortality and decreased healthcare costs.

Note:

Funding Information: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Declaration of Interests: The Authors declare that there is no conflict of interest.

Keywords: Pulmonary hypertension, Epidemiology, all-cause mortality, health care cost