Pulmonary hypertension in the cardiac intensive care unit was associated with increased in-hospital mortality compared to patients without PH (10.9% vs. 4.2%; adjusted OR 1.40; 95% CI 1.03-1.92).
Cohort (n=5,042)
Does the presence of pulmonary hypertension increase the risk of in-hospital mortality in cardiac intensive care unit patients?
Pulmonary hypertension is highly prevalent in the cardiac intensive care unit and is independently associated with an increased risk of in-hospital mortality.
Effect estimate: adjusted OR 1.40 (95% CI 1.03-1.92)
Absolute Event Rate: 10.9% vs 4.2%
p-value: p=0.03
AIMS: Pulmonary hypertension (PH) has been consistently associated with adverse outcomes in hospitalized patients. Limited epidemiologic data exist regarding PH in the cardiac intensive care unit (CICU) population. Here, we describe the prevalence, aetiology, and outcomes of PH in the CICU. METHODS AND RESULTS: Cardiac intensive care unit patients admitted from 2007 to 2018 who had right ventricular systolic pressure (RVSP) measured via transthoracic echocardiography near CICU admission were included. PH was defined as RVSP >35 mmHg, and moderate-to-severe PH as RVSP ≥50 mmHg. Predictors of in-hospital mortality were determined using multivariable logistic regression. Among 5042 patients (mean age 69.4 ± 14.8 years; 41% females), PH was present in 3085 (61%). The majority (68%) of patients with PH had left heart failure, and 29% had lung disease. In-hospital mortality occurred in 8.3% and was more frequent in patients with PH 10.9% vs. 4.2%, adjusted odds ratio (OR) 1.40, 95% confidence interval (CI) 1.03-1.92, P = 0.03, particularly patients with moderate-to-severe PH (14.4% vs. 6.2%, adjusted OR 1.65, 95% CI 1.27-2.14, P < 0.001). In-hospital mortality increased incrementally as a function of higher RVSP (adjusted 1.18 per 10 mmHg increase, 95% CI 1.09-1.28, P < 0.001). Patients with higher RVSP or moderate-to-severe PH had increased in-hospital mortality across admission diagnoses (all P < 0.05). CONCLUSIONS: Pulmonary hypertension is very common in the CICU population and appears to be independently associated with a higher risk of death during hospitalization, although the strength of this association varies according to the underlying admission diagnosis. These data highlight the importance of PH in patients with cardiac critical illness.
Jentzer et al. (Wed,) conducted a cohort in Pulmonary hypertension (n=5,042). Pulmonary hypertension vs. No pulmonary hypertension was evaluated on In-hospital mortality (adjusted OR 1.40, 95% CI 1.03-1.92, p=0.03). Pulmonary hypertension in the cardiac intensive care unit was associated with increased in-hospital mortality compared to patients without PH (10.9% vs. 4.2%; adjusted OR 1.40; 95% CI 1.03-1.92).