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Impact of age and comorbidity on risk stratification in idiopathic pulmonary arterial hypertension

Hjalmarsson, Clara; Rådegran, Göran LU ; Kylhammar, David LU ; Rundqvist, Bengt; Multing, Jonas; Nisell, Magnus D.; Kjellström, Barbro; , and , (2018) In European Respiratory Journal 51(5).
Abstract

Recent reports from worldwide pulmonary hypertension registries show a new demographic picture for patients with idiopathic pulmonary arterial hypertension (IPAH), with an increasing prevalence among the elderly. We aimed to investigate the effects of age and comorbidity on risk stratification and outcome of patients with incident IPAH. The study population (n=264) was categorised into four age groups: 18-45, 46-64, 65-74 and 75 years. Individual risk profiles were determined according to a risk assessment instrument, based on the European Society of Cardiology and the European Respiratory Society guidelines. The change in risk group from baseline to follow-up (median 5 months) and survival were compared across age groups. In the two... (More)

Recent reports from worldwide pulmonary hypertension registries show a new demographic picture for patients with idiopathic pulmonary arterial hypertension (IPAH), with an increasing prevalence among the elderly. We aimed to investigate the effects of age and comorbidity on risk stratification and outcome of patients with incident IPAH. The study population (n=264) was categorised into four age groups: 18-45, 46-64, 65-74 and 75 years. Individual risk profiles were determined according to a risk assessment instrument, based on the European Society of Cardiology and the European Respiratory Society guidelines. The change in risk group from baseline to follow-up (median 5 months) and survival were compared across age groups. In the two youngest age groups, a significant number of patients improved (18-45 years, Z= −4.613, p<0.001; 46-64 years, Z= −2.125, p=0.034), but no significant improvement was found in the older patient groups. 5-year survival was highest in patients aged 18-45 years (88%), while the survival rates were 63%, 56% and 36% for patients in the groups 46-64, 65-74 and 75 years, respectively (p<0.001). Ischaemic heart disease and kidney dysfunction independently predicted survival. These findings highlight the importance of age and specific comorbidities as prognostic markers of outcome in addition to established risk assessment algorithms.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Respiratory Journal
volume
51
issue
5
publisher
Eur Respiratory Soc
external identifiers
  • scopus:85047367187
ISSN
0903-1936
DOI
10.1183/13993003.02310-2017
language
English
LU publication?
yes
id
c1dc1fca-f8de-45c5-8ada-b5eb96bde34f
date added to LUP
2018-06-01 15:12:41
date last changed
2019-02-20 11:18:54
@article{c1dc1fca-f8de-45c5-8ada-b5eb96bde34f,
  abstract     = {<p>Recent reports from worldwide pulmonary hypertension registries show a new demographic picture for patients with idiopathic pulmonary arterial hypertension (IPAH), with an increasing prevalence among the elderly. We aimed to investigate the effects of age and comorbidity on risk stratification and outcome of patients with incident IPAH. The study population (n=264) was categorised into four age groups: 18-45, 46-64, 65-74 and 75 years. Individual risk profiles were determined according to a risk assessment instrument, based on the European Society of Cardiology and the European Respiratory Society guidelines. The change in risk group from baseline to follow-up (median 5 months) and survival were compared across age groups. In the two youngest age groups, a significant number of patients improved (18-45 years, Z= −4.613, p&lt;0.001; 46-64 years, Z= −2.125, p=0.034), but no significant improvement was found in the older patient groups. 5-year survival was highest in patients aged 18-45 years (88%), while the survival rates were 63%, 56% and 36% for patients in the groups 46-64, 65-74 and 75 years, respectively (p&lt;0.001). Ischaemic heart disease and kidney dysfunction independently predicted survival. These findings highlight the importance of age and specific comorbidities as prognostic markers of outcome in addition to established risk assessment algorithms.</p>},
  articleno    = {1702310},
  author       = {Hjalmarsson, Clara and Rådegran, Göran and Kylhammar, David and Rundqvist, Bengt and Multing, Jonas and Nisell, Magnus D. and Kjellström, Barbro and ,  and , },
  issn         = {0903-1936},
  language     = {eng},
  month        = {05},
  number       = {5},
  publisher    = {Eur Respiratory Soc},
  series       = {European Respiratory Journal},
  title        = {Impact of age and comorbidity on risk stratification in idiopathic pulmonary arterial hypertension},
  url          = {http://dx.doi.org/10.1183/13993003.02310-2017},
  volume       = {51},
  year         = {2018},
}