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Influence of Pulmonary Hypertension on Survival in Advanced Lung Disease

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Abstract

Background

Effects of pulmonary hypertension (PH) in advanced lung disease remain unclear.

Methods

The United Network for Organ Sharing database was queried from 1987 to 2013 to assess survival lung transplant candidates to determine influence of PH in advanced lung disease. Thresholds included mean pulmonary artery pressure ≥25 mmHg (mild PH) and 35 mmHg (severe PH).

Results

Of 12,405 listed possible candidates, 10,158 were used for univariate analysis, 7050 for Kaplan–Meier (KM) function, 6196 for multivariate Cox models, and 5328 (mild PH) and 1910 (severe PH) for propensity score matching (PSM). For mild and severe PH, univariate revealed that PH was associated with survival difference (HR = 1.530, 95 % CI 1.416, 1.654, p < 0.001) and (HR = 2.033, 95 % CI 1.851, 2.232, p < 0.001), respectively. KM function curves demonstrated a significant difference for mild PH (Log-rank test: Chi square (df = 1): 117.76, p < 0.0001) and severe PH (Log-rank test: Chi square (df = 1): 230.91, p < 0.0001). Multivariate Cox models also found a significant increased risk for death for mild PH (HR = 1.750, 95 % CI 1.606, 1.907, p < 0.001) and severe PH (HR = 2.088, 95 % CI 1.879, 2.319, p < 0.001). PSM confirmed this increased risk for death for mild PH (HR = 1.695, 95 % CI 1.502, 1.914, p < 0.001) and severe PH (HR = 1.976, 95 % CI 1.641, 2.379, p < 0.001).

Conclusions

PH is associated with significant increased risk for death in patients with advanced lung disease.

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Acknowledgments

The authors would like to acknowledge Dmitry Tumin for his statistical expertise in the data analysis. No funding was required to complete this work.

Conflict of interest

The authors report no conflicts of interest and have no relevant disclosures.

Author information

Authors and Affiliations

  1. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    Don Hayes Jr.

  2. Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA

    Don Hayes Jr.

  3. Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA

    Sylvester M. Black & Bryan A. Whitson

  4. Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA

    Joseph D. Tobias

  5. Section of Pulmonary Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Don Hayes Jr.

  6. Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Joseph D. Tobias

  7. Skaggs Pharmaceutical Sciences Center, The University of Arizona-Tucson College of Pharmacy, Tucson, AZ, USA

    Heidi M. Mansour

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  1. Don Hayes Jr.
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  2. Sylvester M. Black
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Correspondence to Don Hayes Jr..

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Hayes, D., Black, S.M., Tobias, J.D. et al. Influence of Pulmonary Hypertension on Survival in Advanced Lung Disease. Lung 193, 213–221 (2015). https://doi.org/10.1007/s00408-015-9696-8

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  • DOI: https://doi.org/10.1007/s00408-015-9696-8

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