(276) Pulmonary Hypertension and Mortality Predictors in Patients With Diastolic Dysfunction

Introduction: Pulmonary hypertension (PH) is a serious condition commonly associated with diastolic left ventricular (LV) dysfunction. This study aimed to analyze the presence or absence of pulmonary hypertension and identify significant predictors of mortality in a large cohort of patients with diastolic dysfunction.

Methods: A retrospective analysis was performed using the 2020 National Inpatient Sample, including 422,750 patients diagnosed with acute, chronic, acute on chronic, or unspecified diastolic LV dysfunction. Patients were categorized into two groups based on the presence or absence of Group-II PH (pulmonary hypertension). Key summary statistics and logistic multivariate regression were utilized to identify mortality predictors.

Results: Among the study cohort, 0.90% (n = 3,796) had Group-II PH, while 99.10% (n = 418,954) did not. Age distribution between the two groups showed a marginal difference (p = 0.061). Female patients were more prevalent in the Group-II PH cohort (p < 0.0001). Racial distribution exhibited a significant association with the presence of Group-II PH (p < 0.0001). Primary payer status also showed a strong association (p < 0.0001), with Medicare patients. Region of hospitalization had a considerable impact on the distribution of patients (p < 0.0001). Logistic multivariate regression revealed several significant mortality predictors in patients with diastolic dysfunction and Group-II PH. Advanced age exhibited a higher risk of mortality (p < 0.0001), while female gender showed a protective effect (p < 0.0001). Racial disparities were evident, with Native American patients at the highest risk of mortality (p < 0.0001). Hospitalization in different regions significantly influenced patient outcomes, with the Northeast and Midwest showing lower risks compared to the South (p < 0.0001). Several comorbidities, including myocardial infarction (p < 0.0001) and dementia (p < 0.0001), were associated with increased mortality risk.

Conclusions: This study provides valuable insights into the prevalence of pulmonary hypertension in patients with diastolic dysfunction and identifies important mortality predictors. These findings may contribute to the development of personalized management approaches and improved care for this complex patient population.