Details

Autor(en) / Beteiligte

• Kiely, David G
• Hamilton, Neil
• Wood, Steven
• Durrington, Charlotte
• Exposto, Fernando
• Muzwidzwa, Ruvimbo
• Raiteri, Louise
• Beaudet, Amélie
• Muller, Audrey
• Sauter, Rafael
• Pillai, Nadia
• Lawrie, Allan
• Condliffe, Robin
• Elliot, Charlie
• Hameed, Abdul
• Charalampopoulos, Athanasios
• Rothman, Alex
• Roger Thompson, AA
• Hurdman, Judith
• Armstrong, Iain
• Lewis, Robert A
• Watson, Lisa
• Swift, Andrew J
• Rajaram, Smitha
• Billings, Catherine
• Quadery, Rehan
• Wild, Jim

Titel

Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service

Ist Teil von

• BMJ open, 2024-01, Vol.14 (1), p.e080068-e080068

Ort / Verlag

England: British Medical Journal Publishing Group

Erscheinungsjahr

2024

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• ObjectivesThis study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH).DesignRetrospective observational study.SettingPulmonary hypertension referral centre in the UK.ParticipantsAdults diagnosed with CTEPH between 1 January 2012 and 30 June 2019 were included. Cohorts were retrospectively defined for operated patients (received pulmonary endarterectomy (PEA)) and not operated; further subgroups were defined based on risk score (low, intermediate or high risk for 1-year mortality) at diagnosis.Primary and secondary outcome measuresDemographics, clinical characteristics, comorbidities, treatment patterns, HRQoL, HCRU, costs and survival outcomes were analysed.ResultsOverall, 683 patients were analysed (268 (39%) operated; 415 (61%) not operated). Most patients in the operated and not-operated cohorts were intermediate risk (63%; 53%) or high risk (23%; 31%) at diagnosis. Intermediate-risk and high-risk patients had higher HCRU and costs than low-risk patients. Outpatient and accident and emergency visits were lower postdiagnosis for both cohorts and all risk groups versus prediagnosis. HRQoL scores noticeably improved in the operated cohort post-PEA, and less so in the not-operated cohort at 6–18 months postdiagnosis. Survival at 5 years was 83% (operated) and 49% (not operated) and was lower for intermediate-risk and high-risk patients compared with low-risk patients.ConclusionsFindings from this study support that risk assessment at diagnosis is prognostic for mortality in patients with CTEPH. Low-risk patients have better survival and HRQoL and lower HCRU and costs compared with intermediate-risk and high-risk patients.