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A DECLINE IN UNITED STATES NATIONAL TREND OF DIABETES AMONG PATIENTS ADMITTED WITH PULMONARY ARTERIAL HYPERTENSION FROM 2015 TO 2018

      TOPIC: Pulmonary Vascular Disease
      TYPE: Original Investigations
      PURPOSE: Advancement in the therapy in pulmonary arterial hypertension (PAH) have shown improved survivals, but recent longitudinal studies in the United States hospitalizations have shown conflicting results. This study was conducted to determine the age- and gender-adjusted national trends in PAH-related hospitalizations in the United States using the largest nationally representative database.
      METHODS: We performed a cross-sectional study of the National Inpatient Sample database for all adult patients (≥ 18 years old) with PAH as the principal diagnosis from October 1, 2015 to December 31, 2018. We analyzed the age- and gender-adjusted longitudinal trends in hospital admissions, in-hospital mortality, hospital charges, and hospital length of stay.
      RESULTS: Between 2015 and 2018, the number of PAH-related hospitalizations and in-hospital mortality has remained stable. There was a significant increase in hospital charges and hospital length of stay (p<0.05). Admission to tertiary teaching hospitals similarly increased. There was a significant decrease in proportion of co-morbid condition of diabetes among PAH patients from 2015 to 2018 (p=0.01).
      CONCLUSIONS: Analyses of temporal changes in PAH showed stable hospitalizations and in-hospital mortality among patients with PAH, with a decrease in proportion of co-morbid condition of diabetes. Hospital charges and hospital length of stay have substantially increased.
      CLINICAL IMPLICATIONS: Further studies should be conducted exploring the relationship of diabetes and PAH to aid understanding of the disease process and provide optimal care. Despite the literature prior to 2013 showing a decrease in PAH hospitalization, we observed a non-significant trend after age and gender adjustment. This may imply a change in demographics (age, gender). In contrast, hospital charges and hospital length of stay have substantially increased, likely reflecting new treatment options that poses additional cost of care though unclear long term benefit for patients.
      DISCLOSURES: No relevant relationships by Jeeyune Bahk, source=Web Response
      No relevant relationships by Jennifer Fung, source=Web Response
      No relevant relationships by Kam Sing Ho, source=Web Response