Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 23;10(4):2045894020962917.
doi: 10.1177/2045894020962917. eCollection 2020 Oct-Dec.

Burden of pulmonary hypertension in patients with portal hypertension in the United States: a retrospective database study

Sandeep Sahay  1 , Yuen Tsang  2 , Megan Flynn  2 , Peter Agron  2 , Robert Dufour  2
Affiliations

Burden of pulmonary hypertension in patients with portal hypertension in the United States: a retrospective database study

Sandeep Sahay et al. Pulm Circ. .

Abstract

Patients with portal hypertension may develop pulmonary hypertension. The economic implications of these comorbidities have not been systematically assessed. We compared healthcare resource utilization and costs in the United States between patients with co-existing portal hypertension and pulmonary hypertension (pulmonary hypertension cohort) and a matched cohort of portal hypertension patients without pulmonary hypertension (control cohort). In this retrospective analysis, adult pulmonary hypertension and control patients were identified from the Optum® Clinformatics® Data Mart database between 1 July 2014 and 30 June 2018. All patients had ≥2 claims with diagnosis codes for portal hypertension; pulmonary hypertension patients had ≥2 claims with diagnosis codes for pulmonary hypertension; controls could not have pulmonary hypertension diagnoses or any claims for pulmonary arterial hypertension-specific medications. Controls were matched to pulmonary hypertension patients by age, sex, Charlson comorbidity index score, and liver diseases. We assessed 12-month healthcare resource utilization and costs. Each cohort included 146 patients. During follow-up, pulmonary hypertension cohort patients were more likely than controls to experience a hospitalization (51% vs. 32%, P = 0.0014) and an emergency room visit (55% vs. 41%, P = 0.026). The average annual total cost was higher in pulmonary hypertension patients than for matched controls ($119,912 vs. $81,839, P < 0.0001). After covariate adjustment, costs for pulmonary hypertension cohort patients were 1.47 times higher than those for controls (P = 0.0197). These findings suggest that patients with portal hypertension and co-existing pulmonary hypertension are at a greater risk for hospitalization and incur higher mean annual total costs than portal hypertension patients without pulmonary hypertension.

Keywords: healthcare resource utilization; hospitalization; portal hypertension; portopulmonary hypertension; pulmonary arterial hypertension.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SS has served on advisory committees for Actelion, Bayer and United Therapeutics, and has received consultancy, steering committee, and speaker bureau fees from Actelion, Bayer and United Therapeutics; travel/accommodation reimbursement from Actelion for presenting at the International Society for Heart and Lung Transplantation meeting 2019; and grant support from the ACCP Chest PAH Research Award 2017. YT, MF, PA, and RD are employees of Actelion Pharmaceuticals US, Inc., a Janssen Pharmaceutical Company of Johnson & Johnson, and hold stock in Johnson & Johnson.

Figures

Fig. 1.
Fig. 1.
Study design. Control patients had no PH diagnosis during the study period. PH: pulmonary hypertension.
Fig. 2.
Fig. 2.
Ascertainment of the PH cohort (portal hypertension with PH). PH: pulmonary hypertension.
Fig. 3.
Fig. 3.
Kaplan–Meier curves with 95% confidence intervals for all-cause hospitalization in portal hypertension patients with PH (PH cohort) and controls with portal hypertension but without PH, matched by propensity score. PH: pulmonary hypertension.
See this image and copyright information in PMC

References

    1. Fritz JS, Fallon MB, Kawut SM. Pulmonary vascular complications of liver disease. Am J Respir Crit Care Med 2013; 187: 133–143. - PMC - PubMed
    1. Galiè N, Hoeper MM, Humbert M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 2009; 30: 2493–2537. - PubMed
    1. Humbert M, Guignabert C, Bonnet S, et al. Pathology and pathobiology of pulmonary hypertension: state of the art and research perspectives. Eur Respir J 2019; 53: 1801887. - PMC - PubMed
    1. Simonneau G, Gatzoulis MA, Adatia I, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62: D34–D41. - PubMed
    1. Simonneau G, Montani D, Celermajer DS, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J 2019; 53: 1801913. - PMC - PubMed

LinkOut - more resources