PURPOSE: PAH is associated with right ventricular failure and has significant morbidity and mortality. Limited data is available regarding the impact of PAH on mortality due to CAP or sepsis. Therefore our aim was to examine the impact of PAH on 30-day mortality for patients hospitalized with CAP or sepsis.
METHODS: A retrospective national cohort study conducted using Department of Veterans Affairs (VA) administrative data of patients hospitalized with sepsis or CAP in fiscal year (FY) 2000 and having at least one year of prior VA outpatient care. Patients were > 64 year of age, had at least one outpatient clinic visit during FY 1999, and hospitalized with an ICD-9 discharge diagnosis of CAP or sepsis. We identified PAH using ICD-9 criteria. Our primary analyses were 2 separate multilevel regression models, one for CAP and one for sepsis, with the dependent variable of 30-day mortality.
RESULTS: We identified 8652 patients hospitalized with CAP and 3018 with sepsis that met our inclusion/exclusion criteria. For the CAP cohort, the mean age was 75.5 years and 9.9% of patients died within 30-days of presentation, and for the sepsis cohort, the mean age was 74.4 years and 27% died within 30-days. There were 586 patients (6.8%) with PAH in the CAP cohort and 129 (4.3%) in the sepsis cohort. After adjusting for potential confounders, PAH was not associated with 30-day mortality in the CAP (odds ratio 1.14; 95% confidence interval 0.86–1.52) or sepsis (0.93, 0.59–1.44) cohorts.
CONCLUSION: PAH was not associated with 30-day mortality in patients hospitalized with CAP or sepsis. In contrast to our a priori hypothesis, PAH was not associated with 30-day mortality.
CLINICAL IMPLICATIONS: Further research is needed to examine the association of PAH on outcomes for patients with serious infectious diseases.
DISCLOSURE: Rosa Malo de Molina, No Financial Disclosure Information; No Product/Research Disclosure Information