Background: Pulmonary hypertension (PH) is a frequently encountered condition of various etiologies. Until now, there is limited data exists regarding the healthcare utilization, medical costs, and prognosis of PH across the five diagnostic groups.
Methods: We identified 2,185 patients with PH, defined as the peak TR velocity >3.4 m/sec, among the consecutive patients who were referred for echocardiography between 2009 and 2015. Using electronic medical record, the enrolled patients were classified according to the five diagnostic groups by World Health Organization (WHO) classification. Healthcare utilization, costs, and all-cause mortality were assessed across the five diagnostic groups.
Results: During a median of 32.4 months (IQR, 16.2 - 57.8), 749 patients (34.3%) died. Annualized mortality rate (AMR; per 100 person-year) was the highest in group III (28.5) and lowest in group I (7.6). Among the group I patients, those with connective tissue disease had the highest AMR (10.4) and those with idiopathic PAH had the second-highest AMR (10.2). Patients of group V and group II had more hospitalizations than other groups (3.1 [IQR, 0.4 - 10.9] days/year and 2.7 [IQR, 0.0 - 8.3] days/year, respectively). Patients in group V spent the largest amount of medical costs (5738.5 [IQR, 2094.4 - 20047.9] $USD/year), followed by group II and group I.
Conclusions: Healthcare utilization, medical costs, and risk of mortality differed across the five diagnostic groups of PH. Current classification system by WHO provides not only prognostic value but also the burden of disease on healthcare utilization and costs, suggesting the importance of systematic evaluation of patients with PH.