Abstract 15721: Gender Differences in Temporal Trends and Outcomes of Pulmonary Arterial Hypertension-Related Hospitalizations in the US

Abstract

Introduction: There is limited data on the gender differences in the trend of hospitalizations related to PAH and associated outcomes in the US Methods: We queried the National Inpatient Sample from 2010 to 2019 to identify PAH admissions using international classification of diseases (ICD) codes 416.0 (ICD-9) and I27.0 (ICD-10) Results: 20,513 hospitalizations with PAH as the primary diagnosis was analyzed during the study period. There were 13,928 women (67.9%) and 6,584 (32.1%) men. The mean age among women (SD) and men (SD) were 66 years (16) and 65 years (17) respectively. Between 2010 and 2019, PAH hospitalization rates declined in both women (13.5% vs. 8.5%], P < 0.001) and men (14.2% vs. 8.3%, P = 0.027. The overall mortality rate was higher in men compared with women (6.6% vs. 5.7%, P = 0.015. Though crude mortality rates declined for the total population, this was statistically significant only among women (6.7% vs.5.6%, P = 0.011). On adjusted multivariate analysis, factors associated with increased odds of inpatient mortality among women were age 45 - 64 years (OR 1.62, 95% CI 1.11 - 2.37, P = 0.013) and > 65 years (OR 2.36, 95% CI 1.57 - 3.55, P<0.001) compared with age 18-44 years. Black (OR 1.44, 95% CI 1. 13 - 1.78, P < 0.001) and Hispanic race/ethnicity (OR 1.06, 95% CI 1.02 - 1.51, P = 0.037), compared with White race/ethnicity. Comorbidities and in-hospital complications associated with increased mortality were chronic kidney disease, acute pulmonary embolism (PE), and acute respiratory failure (ARF). Among men, age > 65 years (OR 3.28, 95% CI 1.68 - 6.41, P = 0.001), Black (OR 1.9, 95% CI 1.36 - 2.91, p < 0.001) and Hispanic race/ethnicity (OR 1.21, 95% CI 1.08 - 1.78, P = 0.021), compared with White race/ethnicity were associated with increased odds of mortality. The presence of congestive heart failure and complications of acute PE, ARF, acute ischemic stroke, and atrial fibrillation were also associated with increased mortality. Conclusions: From 2010 to 2019 in the US, PAH-related hospitalization rates decreased in both women and men while mortality only decreased among women. Men were more likely to die during hospitalization compared with women. Older age and Black and Hispanic race/ethnicity were associated with higher mortality in both women and men.