Any newly-diagnosed pulmonary arterial hypertension (PAH) patient could probably testify to the hardships of having the disease, and new research provides concrete evidence of a substantial burden. More than half of these patients are hospitalized within three years of their diagnosis.
Lead author Charles Burger, MD, from the Mayo Clinic, and colleagues reported their findings in Chest. Data was gathered for 862 patients, and 490 (56.8%) experienced at least one hospitalization during their first three years post-diagnosis. 490 of the total had experienced at least one hospitalization during the 3-year follow-up period. 52.4% of the hospital admissions were PAH-related, while 43.7% were unrelated to the disease and 3.9% were due to undetermined causes. Half were related to the patients’ PAH, and the mean total number of days spent in the hospital was 15.3 days. Not only is a hospital stay burdensome to patients, but also it places a burden on the healthcare system.
“Our findings clearly demonstrate that all-cause hospitalization is very common among newly diagnosed patients,” wrote Dr. Burger. The authors concluded that PAH-related hospitalizations were associated with poor survival at three years post-diagnosis and re-hospitalization. Only a quarter of PAH-related hospitalization patients were hospitalization-free for three years.
Congestive heart failure and placement or removal of a central venous catheter were the most common causes for PAH-related hospitalization, and most hospitalized patients were on parenteral therapy. Other risk factors included comorbidities and more severe PAH at the time of enrollment for the study, but the two groups were not significantly different in severity at the time of enrollment.
Survival after three years post-discharge was 56.8% for PAH-related hospitalization patients, compared to 67.8% for PAH-unrelated hospitalization patients.
Patient data was made available through the Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL). This was a registered observational clinical trial with the primary outcome measure of survival and secondary outcome measures of clinical predictors and precise outcome definitions. It was initiated in March 2006, and 54 study locations took part in the study, which was sponsored by Actelion.