Pulmonary Vascular Disease |

Echocardiographic Evidence of Pulmonary Hypertension and Outcomes in COPD Patients FREE TO VIEW

Prangthip Charoenpong, MD; Clifton Clarke, MD
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Advocate Illinois Masonic Medical Center, Chicago, IL

Chest. 2014;146(4_MeetingAbstracts):846A. doi:10.1378/chest.1995083
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SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters IV

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: COPD can cause secondary PH. The pathophysiology is chronic inflammation, epithelial dysfunction and hypoxemia. Echocardiography is a non-invasive test that can reveal signs of PH. We would like to study the outcomes ie. mortality rate at 1 year(MR), length of stay(LOS), hospitalization cost, readmission rate at 1 year of COPD patients whose echocardiography showed PH defined by right ventricular systolic pressure(RVSP) more than 35 mmHg.

METHODS: This study is a retrospective review of 136 patients hospitalized for AECOPD in 2011. Out of 136 patients, 73 had echocardiography done during the admission. The demographic data, clinical manifestation, laboratory findings, echocardiographic report including RVSP were collected from medical record. Patients whose LVEF was less than 55% were excluded. LOS, MR, hospitalization cost and readmission rate were compared between PH group and non-PH group.

RESULTS: From 73 patients(70.7±11.8 years old, 50.7 % male), 22 patients were found to have PH(30.1%), whereas 51 patients were in non-PH group. When compared between PH group and non-PH group, LOS were 5.6vs3.4(p=0.07) days, hospitalization cost were 44,822vs34,885(p=0.36) dollars, readmission rate in 1 year were 1.6vs1.1(p=0.34) times and MR were 27.3%vs19.6%(p=0.54) respectively. The PH group had a longer LOS, higher cost, MR and readmission rate although the result from our study is not statistically significant which might be explained by small size of population or the limitation of measuring RVSP by echocardiography that can have error up to 10-20 mmHg.

CONCLUSIONS: Despite non-statistically significant results in this study, PH tends to worsen the outcome of COPD patients. COPD patients who have PH should have close follow-up after being discharge. Echocardiography should be implemented in the assessment of COPD patient as a screening test for PH.

CLINICAL IMPLICATIONS: PH should be identified in COPD patient given that it can affect overall prognosis of patients. Echocardiography can be use as a screening test.

DISCLOSURE: The following authors have nothing to disclose: Prangthip Charoenpong, Clifton Clarke

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