Impact of pulmonary hypertension on outcomes of influenza pneumonia patients: A nationwide analysis

Abstract

Background: Pulmonary hypertension can be a significant cause of morbidity and mortality for influenza pneumonia (IP) patients. We performed analysis from the multicentric National Inpatient Sample (NIS) datasets to study the influence of disorders of pulmonary hypertension on the outcomes in IP patients. Methods: We used NIS 2016–2019 to identify IP hospitalizations (between 22–90 years of age) and divided them into with and without pulmonary hypertension (herein PHDPC). We analyzed for differences in demographics, primary (all-cause mortality) and other secondary outcomes. Results: Of 353,460 IP hospitalizations, 6.5% had PHDPC. The PHDPC cohort had more elderly, females, African Americans, and Medicare enrollees predominantly with more hospitalizations to large bed sizes and urban teaching hospitals, and higher cardiovascular comorbidities than non-PHDPC cohort. PHDPC had higher primary outcomes for in-hospital mortality (8.9% vs. 5.8%, adjusted OR 1.4, 95% CI: 1.21–1.61). PHDPC also had higher secondary outcomes for sepsis, septic shock, cardiogenic shock and need for mechanical ventilation, prolonged ventilation, hospital resource utilization for longer mean length of stay, mean hospitalization cost, transfer to other facilities or need for home health care, and high risk for 30-day readmission than the non-PHDPC cohort. Conclusions: With our study, we provide contemporary data for the outcomes of IP inpatients with pulmonary hypertension and depict worse outcomes for mortality, complications, and hospital resource utilization. Although our study does not include stratification for vaccination status for the outcome, primary care physicians, cardiologists, and pulmonologists should pro-actively educate patients on preventive strategies during the flu season.