Abstract Rationale Sociodemographic differences contribute to disparities in the prevalence, treatment, and clinical outcomes of many illnesses. Previous research on the influence of these factors in pulmonary arterial hypertension (PAH) has yielded mixed results, especially with regards to race and ethnicity. This retrospective, single-center study evaluates the association of granular sociodemographic variables with PAH outcomes in an ethnically and socioeconomically diverse patient population. Methods Data from 143 patients treated for PAH at Cedars-Sinai Medical Center between 2007 and 2025 was collected from the electronic medical records (EMR), limited to a duration of one-year from the initial visit. The primary composite outcome of interest was the occurrence of either death, lung transplant, or all-cause hospitalization. Multivariate logistic regression was used to calculate odds ratios for age, race, ethnicity, primary language, insurance coverage type, partner status, Area Deprivation Index, pharmaceutical treatment, Elixhauser Comorbidity Index, and REVEAL 2.0 risk score. Cox proportional hazards regression was used to estimate hazard ratios for the same variables, and Kaplan-Meier survival curves and log-rank tests were used to compare event-free survival of each group. All analyses were performed using R version 4.5.1. Results A high REVEAL 2.0 score was associated with an increased odds of the primary outcome (OR: 9.95, 95% CI: 2.91–39.9, p 0.001) compared to a low score and was also associated with decreased event-free survival (HR: 4.5, 95% CI: 1.94–10.4) compared to a low score, redemonstrated by Kaplan-Meier analysis (p 0.001). There was no difference in the odds of the primary outcome based on age, race, ethnicity, primary language, insurance coverage, partner status, or area deprivation index by state decile or national percentile. Conclusion In this single-center sociodemographically diverse PAH cohort, REVEAL 2.0 risk score, an established prognostic indicator of PAH outcome, strongly predicted the likelihood of a clinical event, confirming the external validity of this population; whereas sociodemographic factors including race, area deprivation index, partner status, insurance coverage, and primary language, did not predict the likelihood of a clinical event in the year following the initial visit. These findings suggest that potential sociodemographic disparities in PAH outcomes are complex, may be site- or care-dependent, and reflect efforts to standardize quality care for PAH at a major PH center. Further research to include multi-center data with larger sample sizes is needed to discern the impact of socioeconomical and demographic factors on PAH clinical outcomes. This abstract is funded by: None
Floyd et al. (Fri,) studied this question.