Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension : insights from a UK pulmonary hypertension referral service
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: This study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH).
DESIGN: Retrospective observational study.
SETTING: Pulmonary hypertension referral centre in the UK.
PARTICIPANTS: Adults diagnosed with CTEPH between 1 January 2012 and 30 June 2019 were included. Cohorts were retrospectively defined for operated patients (received pulmonary endarterectomy (PEA)) and not operated; further subgroups were defined based on risk score (low, intermediate or high risk for 1-year mortality) at diagnosis.
PRIMARY AND SECONDARY OUTCOME MEASURES: Demographics, clinical characteristics, comorbidities, treatment patterns, HRQoL, HCRU, costs and survival outcomes were analysed.
RESULTS: Overall, 683 patients were analysed (268 (39%) operated; 415 (61%) not operated). Most patients in the operated and not-operated cohorts were intermediate risk (63%; 53%) or high risk (23%; 31%) at diagnosis. Intermediate-risk and high-risk patients had higher HCRU and costs than low-risk patients. Outpatient and accident and emergency visits were lower postdiagnosis for both cohorts and all risk groups versus prediagnosis. HRQoL scores noticeably improved in the operated cohort post-PEA, and less so in the not-operated cohort at 6-18 months postdiagnosis. Survival at 5 years was 83% (operated) and 49% (not operated) and was lower for intermediate-risk and high-risk patients compared with low-risk patients.
CONCLUSIONS: Findings from this study support that risk assessment at diagnosis is prognostic for mortality in patients with CTEPH. Low-risk patients have better survival and HRQoL and lower HCRU and costs compared with intermediate-risk and high-risk patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
|---|---|
| Enthalten in: |
BMJ open - 14(2024), 1 vom: 04. Jan., Seite e080068 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kiely, David G [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Chronic airways disease |
|---|
| Anmerkungen: |
Date Completed 08.01.2024 Date Revised 01.02.2024 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1136/bmjopen-2023-080068 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366674757 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366674757 | ||
| 003 | DE-627 | ||
| 005 | 20240201232111.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240108s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1136/bmjopen-2023-080068 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1277.xml |
| 035 | |a (DE-627)NLM366674757 | ||
| 035 | |a (NLM)38176861 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kiely, David G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension |b insights from a UK pulmonary hypertension referral service |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.01.2024 | ||
| 500 | |a Date Revised 01.02.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: This study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH) | ||
| 520 | |a DESIGN: Retrospective observational study | ||
| 520 | |a SETTING: Pulmonary hypertension referral centre in the UK | ||
| 520 | |a PARTICIPANTS: Adults diagnosed with CTEPH between 1 January 2012 and 30 June 2019 were included. Cohorts were retrospectively defined for operated patients (received pulmonary endarterectomy (PEA)) and not operated; further subgroups were defined based on risk score (low, intermediate or high risk for 1-year mortality) at diagnosis | ||
| 520 | |a PRIMARY AND SECONDARY OUTCOME MEASURES: Demographics, clinical characteristics, comorbidities, treatment patterns, HRQoL, HCRU, costs and survival outcomes were analysed | ||
| 520 | |a RESULTS: Overall, 683 patients were analysed (268 (39%) operated; 415 (61%) not operated). Most patients in the operated and not-operated cohorts were intermediate risk (63%; 53%) or high risk (23%; 31%) at diagnosis. Intermediate-risk and high-risk patients had higher HCRU and costs than low-risk patients. Outpatient and accident and emergency visits were lower postdiagnosis for both cohorts and all risk groups versus prediagnosis. HRQoL scores noticeably improved in the operated cohort post-PEA, and less so in the not-operated cohort at 6-18 months postdiagnosis. Survival at 5 years was 83% (operated) and 49% (not operated) and was lower for intermediate-risk and high-risk patients compared with low-risk patients | ||
| 520 | |a CONCLUSIONS: Findings from this study support that risk assessment at diagnosis is prognostic for mortality in patients with CTEPH. Low-risk patients have better survival and HRQoL and lower HCRU and costs compared with intermediate-risk and high-risk patients | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Chronic airways disease | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Quality of Life | |
| 700 | 1 | |a Hamilton, Neil |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a Durrington, Charlotte |e verfasserin |4 aut | |
| 700 | 1 | |a Exposto, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Muzwidzwa, Ruvimbo |e verfasserin |4 aut | |
| 700 | 1 | |a Raiteri, Louise |e verfasserin |4 aut | |
| 700 | 1 | |a Beaudet, Amélie |e verfasserin |4 aut | |
| 700 | 1 | |a Muller, Audrey |e verfasserin |4 aut | |
| 700 | 1 | |a Sauter, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Pillai, Nadia |e verfasserin |4 aut | |
| 700 | 1 | |a Lawrie, Allan |e verfasserin |4 aut | |
| 700 | 0 | |a ASPIRE consortium |e verfasserin |4 aut | |
| 700 | 1 | |a Condliffe, Robin |e investigator |4 oth | |
| 700 | 1 | |a Elliot, Charlie |e investigator |4 oth | |
| 700 | 1 | |a Hameed, Abdul |e investigator |4 oth | |
| 700 | 1 | |a Charalampopoulos, Athanasios |e investigator |4 oth | |
| 700 | 1 | |a Rothman, Alex |e investigator |4 oth | |
| 700 | 1 | |a Roger Thompson, A A |e investigator |4 oth | |
| 700 | 1 | |a Hurdman, Judith |e investigator |4 oth | |
| 700 | 1 | |a Armstrong, Iain |e investigator |4 oth | |
| 700 | 1 | |a Lewis, Robert A |e investigator |4 oth | |
| 700 | 1 | |a Watson, Lisa |e investigator |4 oth | |
| 700 | 1 | |a Swift, Andrew J |e investigator |4 oth | |
| 700 | 1 | |a Rajaram, Smitha |e investigator |4 oth | |
| 700 | 1 | |a Billings, Catherine |e investigator |4 oth | |
| 700 | 1 | |a Quadery, Rehan |e investigator |4 oth | |
| 700 | 1 | |a Wild, Jim |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t BMJ open |d 2012 |g 14(2024), 1 vom: 04. Jan., Seite e080068 |w (DE-627)NLM215724372 |x 2044-6055 |7 nnns |
| 773 | 1 | 8 | |g volume:14 |g year:2024 |g number:1 |g day:04 |g month:01 |g pages:e080068 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1136/bmjopen-2023-080068 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 14 |j 2024 |e 1 |b 04 |c 01 |h e080068 | ||