Abstract Background Although the prevalence of pulmonary hypertension among black and white individuals are similar, black individuals have been reported to have worse prognosis. However, data on renal outcomes and racial disparities in pulmonary hypertension patients are extremely limited. Purpose To investigate the racial differences in acute renal failure outcome of pulmonary hypertension hospitalizations. Methods We queried 2016–2018 National Inpatient Sample (NIS) database to identify pulmonary hypertension patients using appropriate ICD-10 codes. Race variable in the database was used to categorize pulmonary hypertension patients into Blacks and Others groups (Whites, Hispanics, Asian or Pacific Islanders). We used Chi-square test to evaluate the difference between binary variable, and Student's t- test for differences between continuous variables. Multivariate logistic regression was used in outcomes analysis to adjust for potential hospital and patient level confounders. Results Among the total 1,362,765 pulmonary hypertension patients across three years, 68% (906,994) were Whites, 18.9% (251,530) were Blacks, 7.8% (104,169) Hispanics and 2% (30,139) Asian or Pacific Islanders. Blacks with pulmonary hypertension were younger (mean age, 64.1 vs. 73.1 years; p<0.01), more females (57.4% vs. 42.5%; p<0.01), higher prevalence of diabetes (47.2% vs. 39.9%; p<0.01), systolic heart failure (31.2% vs. 25.1%; p<0.01), chronic kidney disease (43.2% vs. 36.4%; p<0.01), end-stage renal disease (17.1% vs. 6.8%; p<0.01), obesity, obstructive sleep apnea and anemia compared to Other races. After adjusting for hospital and patient level confounders including above mentioned comorbidities, Blacks had higher odds of acute renal failure compared to Others [Adjusted Odds ratio: 1.15 (1.11 – 1.18); p<0.01]. Blacks with pulmonary hypertension were also associated with unadjusted longer length of stay (7.0 vs. 6.4 days; p<0.01) and similar total hospitalization charges (USD: $78,408 vs. $80,076; p=0.18) compared to Others. Conclusions Racial minorities are underrepresented among patients with pulmonary hypertension. Blacks with pulmonary hypertension have higher co-morbidity and are associated with worse in-hospital renal outcomes compared to other races. They are also associated with longer length of stay. Vigilant renal functions monitoring, and early nephrologists involvement are needed during hospitalization to prevent worse renal outcomes in this patient population. Funding Acknowledgement Type of funding sources: None.
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Jan 1, 2024
Endurance Evbayekha + 5
Open Access