Format

Send to

Choose Destination
See comment in PubMed Commons below
Chest. 2014 Nov;146(5):1263-1273. doi: 10.1378/chest.14-0193.

Characterization of first-time hospitalizations in patients with newly diagnosed pulmonary arterial hypertension in the REVEAL registry.

Author information

1
From the Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL. Electronic address: burger.charles@mayo.edu.
2
Department of Clinical Research, Mayo Clinic, Jacksonville, FL.
3
ICON Clinical Research, San Francisco, CA.
4
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
5
Actelion Pharmaceuticals US, Inc, South San Francisco, CA.
6
Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL.

Abstract

BACKGROUND:

Hospitalization is an important outcome in pulmonary arterial hypertension (PAH), shown previously to correlate with survival. Using the Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL Registry), we sought to characterize first-time hospitalizations and their effect on subsequent hospitalization and survival in patients with newly diagnosed disease.

METHODS:

Patients with newly diagnosed PAH (n = 862, World Health Organization group 1) were evaluated for first-time hospitalization. The hospitalizations were categorized as PAH related or PAH unrelated based on the case report form. Categories for PAH-related and PAH-unrelated hospitalization were defined before independent review. Patient demographics and disease characteristics are described as well as freedom from hospitalization and survival.

RESULTS:

Of 862 patients, 490 (56.8%) had one or more hospitalizations postenrollment: 257 (52.4%) PAH related, 214 (43.7%) PAH unrelated, and 19 (3.9%) of undetermined causes. The most common causes of PAH-related hospitalization were congestive heart failure and placement/removal of a central venous catheter. Patients with PAH-related hospitalizations were more likely to receive parenteral therapy, be in functional class III/IV, and have higher risk scores before hospitalization at enrollment. Following discharge, 25.4% ± 3.2% and 31.0% ± 4.0% of patients with PAH-related and PAH-unrelated first hospitalization, respectively, remained hospitalization-free for 3 years (P = .11). Survival estimates at 3 years postdischarge were 56.8% ± 3.5% and 67.8% ± 3.6% (P = .037) for patients with PAH-related and PAH-unrelated hospitalization, respectively.

CONCLUSIONS:

In the REVEAL Registry, PAH-related hospitalization was associated with relatively more rehospitalizations and worse survival at 3 years.

TRIAL REGISTRY:

ClinicalTrials.gov; No.: NCT00370214; URL: www.clinicaltrials.gov.

PMID:
24901386
PMCID:
PMC4219341
DOI:
10.1378/chest.14-0193
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center