248: EPIDEMIOLOGY AND OUTCOMES OF PULMONARY HYPERTENSION AMONG PATIENTS WITH TAKAYASU ARTERITIS

Abstract

Introduction: According to a study published in Journal of Rheumatology, the reported prevalence of secondary pulmonary hypertension (PHTN) in patients with takayasu’s arteritis (TA) varies 13.3% to 61.7% with 7 times higher risk of mortality. But the accurate US national data predicting outcomes of PHTN with TA were limited. Aims: Primary aim of our study was to identify national prevalence and outcomes of PHTN amongst patients with TA. Methods: A population-based cross-sectional study was performed in adult US hospitalizations from the nationwide inpatient sample (NIS-2016-2018). We identified patients with TA and sub-grouped into patients with and without PHTN using ICD-10 codes. Univariate analysis was performed using unpaired students’ t-test and chi-square test to identify prevalence, epidemiology, and outcomes of PHTN amongst TA patients. Mix effects multivariate survey logistic regression analyses weighted for variables were performed to identify outcomes (adjusted odds ratio [aOR] and 95% confidence interval [95%CI]) of PTHN amongst TA. p value < 0.05 was considered as significant. Results: Out of 3560 patients with TA, prevalence of PHTN was 6.04%. PHTN patients were older (58 vs 52 years-old) and highly prevalent in age group >75 years (9.3% vs 18-50 years: 3.55%), female (6.82% vs male:2.88%), Native American (40% and Asian:13.51% vs Black:6.19% vs White: 5.57%), and in emergency admissions (7% vs elective:0.89%). (p< 0.0001) Patients with PTHN had a higher frequency of mortality (4.86% vs 2.12%), morbidity (11.49% vs 5.06%), discharge to non-home (55.79% vs 33.22%), disability (81.82% vs 34.91%), and risk of mortality on discharge (69.67% vs 26.11%).(p< 0.0001) In regression analysis, we found TA as an effect modifier to PHTN for increasing odds of disability [aOR 9.10, 95%CI 3.75-22.12, p=0.0274] and risk of mortality [15.26, 6.17-37.70, p< 0.0001]. Conclusions: Poor outcomes and high disability related burden warrants early identification and risk mitigation of secondary pulmonary hypertension amongst patients with takayasu’s arteritis.