Incidence and prevalence of pulmonary hypertension in chronic lung disease: insights from a retrospective cohort study using a UK nationwide health database.
Pulmonary hypertension (PH) associated with lung disease (Group 3 PH) is a serious complication that negatively impacts patient outcomes. This study aimed to assess the epidemiology and disease burden of Group 3 PH in the UK, focusing on interstitial lung disease (ILD-PH).
Retrospective cohort study.
Electronic medical records from the Clinical Practice Research Datalink Aurum, linked to Hospital Episode Statistics.
6690 incident cases of Group 3 PH, including 1561 ILD-PH cases, were identified from a sample of approximately 33 million individuals between January 2017 and December 2019.
Primary outcomes included prevalence and incidence of Group 3 PH and ILD-PH. Secondary outcomes included patient characteristics, overall survival, hospitalisations, outpatient visits and healthcare costs.
Over the 3-year period, prevalence and annual incidence were 139/million (95% CI 134 to 142) and 73/million/year (95% CI 70 to 76) for Group 3 PH and 36/million (95% CI 33 to 37.3) and 17/million/year (95% CI 16 to 19) for ILD-PH. Median overall survival was 19.3 (95% CI 17.77 to 20.8) for Group 3 PH and 15.1 months (95% CI 12.66 to 18.2) for ILD-PH. Following a PH diagnosis, all-cause inpatient visits increased by 33.6% from baseline. The all-cause annual hospitalisation rate was 1.63 (95% CI 1.6 to 1.65) for Group 3 PH and 1.36 (95% CI 1.31 to 1.4) for ILD-PH, with about half linked to PH diagnosis. Pulmonologists were the most consulted specialists, averaging 1.78 (95% CI 1.76 to 1.81) and 2.31 (95% CI 2.25 to 2.37) visits per patient per year for Group 3 PH and ILD-PH, respectively. Annual per-patient costs were £7761 (95% CI 7759 to 7762) for Group 3 PH and £7170 (95% CI 7167.17 to 7173.69) for ILD-PH.
Incidence and prevalence of Group 3 PH in the UK are consistent with other European countries. Patients had poor survival, with PH associated with half of hospital admissions, highlighting the negative impact of PH in chronic lung disease.
Retrospective cohort study.
Electronic medical records from the Clinical Practice Research Datalink Aurum, linked to Hospital Episode Statistics.
6690 incident cases of Group 3 PH, including 1561 ILD-PH cases, were identified from a sample of approximately 33 million individuals between January 2017 and December 2019.
Primary outcomes included prevalence and incidence of Group 3 PH and ILD-PH. Secondary outcomes included patient characteristics, overall survival, hospitalisations, outpatient visits and healthcare costs.
Over the 3-year period, prevalence and annual incidence were 139/million (95% CI 134 to 142) and 73/million/year (95% CI 70 to 76) for Group 3 PH and 36/million (95% CI 33 to 37.3) and 17/million/year (95% CI 16 to 19) for ILD-PH. Median overall survival was 19.3 (95% CI 17.77 to 20.8) for Group 3 PH and 15.1 months (95% CI 12.66 to 18.2) for ILD-PH. Following a PH diagnosis, all-cause inpatient visits increased by 33.6% from baseline. The all-cause annual hospitalisation rate was 1.63 (95% CI 1.6 to 1.65) for Group 3 PH and 1.36 (95% CI 1.31 to 1.4) for ILD-PH, with about half linked to PH diagnosis. Pulmonologists were the most consulted specialists, averaging 1.78 (95% CI 1.76 to 1.81) and 2.31 (95% CI 2.25 to 2.37) visits per patient per year for Group 3 PH and ILD-PH, respectively. Annual per-patient costs were £7761 (95% CI 7759 to 7762) for Group 3 PH and £7170 (95% CI 7167.17 to 7173.69) for ILD-PH.
Incidence and prevalence of Group 3 PH in the UK are consistent with other European countries. Patients had poor survival, with PH associated with half of hospital admissions, highlighting the negative impact of PH in chronic lung disease.
Authors
Kiely Kiely, Wort Wort, Funes Funes, Fernandez Delgado Fernandez Delgado, Petrica Petrica, Proenca Proenca, Bacchini Jeanneret Bacchini Jeanneret
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