National trends and outcomes of hospitalizations for pulmonary hypertension in Spain (2001-2014)

Objective: To assess changes in incidence, diagnostic procedures, comorbidity profiles, length of hospital stay (LOHS), costs, and in-hospital mortality (IHM) for patients hospitalized with pulmonary hypertension (PH). Methods: We included patients hospitalized with PH in Spain from 2001 to 2014. The data were collected from the National Hospital Discharge Database. Results: We included 644,436 discharges (43.31%, males and 56.09% females) admitted for primary PH (8.34%) or secondary PH (91.66%,). The crude incidence rate increased from 58.67 to 148.32 hospitalizations per 100,000 inhabitants between 2001 and 2002 and 2013-2014 (p < 0.001). The percentage of patients with a Charlson co-morbidity index >= 2was 27.87% in 2001-2002, increasing to 47.02% in 2013-2014 (p < 0.001). IHM was 8.77%, with a reduction in the value yielded by the multivariable analysis between 2009 and 2010 and 2013-2014. Median LOHS was 9 +/- 9 days in 2001-2002, which decreased to 7 +/- 8 days in 2013-2014 (p < 0.001). The mean cost per patient increased from (sic)3352.4 +/-(sic)1495 in the period 2001-2002 to (sic)4198.94 +/-(sic)1287.96 in 2013-2014 (p < 0.001). Conclusions: Despite the increase over time in hospital admissions for PH, associated comorbidity, and costs, LOHS and IHM decreased, suggesting that the management of PH-related hospitalizations improved in Spain during the study period. (C) 2018 Elsevier B.V. All rights reserved.