C-41 | Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Trends, Procedural and In-Hospital Outcomes: A Nationwide Cohort Analysis of US (2017-2020)

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, potentially life-threatening disease of the pulmonary vasculature, is a distinct entity (group 4) in the classification of pulmonary hypertension. The available data regarding procedures for CTEPH and hospital outcomes is limited. This analysis included data from the National Inpatient Sample between January 2017 and December 2020. We reported the baseline characteristics and hospital outcomes of hospitalized patients with CTEPH. We also studied the procedural and mortality trends among these patients. We identified 17909 CTEPH hospitalizations during 2017-2020. Median age of identified cases was 63 years, 57% were females and 59% were white. Overall, the inpatient mortality during the study period was 4.89% with nearly stable rates of mortality throughout the studied years. 39.1% of the identified cases developed respiratory failure and 4.75% of them had respiratory failure requiring mechanical ventilation. The most commonly used procedure among the study period was surgical thrombectomy (ST) 9.91% of the cases followed by balloon pulmonary angioplasty (BPA) in 1.79% and then mechanical embolectomy (ME) in 1.2%. We observed increasing trend in ST preference which was associated with 100% mortality with the procedure, however improved mortality in 2020 with ST 62.5%, was seen. The overall length of stay was 6 days while the mean inflation-adjusted cost was $31,490,36. SE has been the most commonly used procedure throughout the studied years and is associated with highest procedural mortality compared to BAP & MT.