دورية أكاديمية
Regional Variation in Pulmonary Arterial Hypertension in the United States: The Pulmonary Hypertension Association Registry.
| العنوان: | Regional Variation in Pulmonary Arterial Hypertension in the United States: The Pulmonary Hypertension Association Registry. |
|---|---|
| المؤلفون: | Fling C; Department of Medicine., De Marco T; Division of Cardiology, University of California, San Francisco, San Francisco, California., Kime NA; Department of Biostatistics., Lammi MR; Division of Pulmonary and Critical Care Medicine, Louisiana State University, New Orleans, Louisiana., Oppegard LJ; Division of Pulmonary and Critical Care Medicine, Oregon Health Sciences University, Portland, Oregon., Ryan JJ; Division of Cardiology, University of Utah, Salt Lake City, Utah., Ventetuolo CE; Department of Medicine and.; Department of Health Services, Policy & Practice, Brown University, Providence, Rhode Island., White RJ; Division of Pulmonary and Critical Care Medicine and.; the Mary M. Parkes Center, University of Rochester, Rochester, New York; and., Zamanian RT; Division of Pulmonary and Critical Care Medicine, Stanford University, Palo Alto, California., Leary PJ; Department of Epidemiology, and.; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington. |
| المصدر: | Annals of the American Thoracic Society [Ann Am Thorac Soc] 2023 Dec; Vol. 20 (12), pp. 1718-1725. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Thoracic Society Country of Publication: United States NLM ID: 101600811 Publication Model: Print Cited Medium: Internet ISSN: 2325-6621 (Electronic) Linking ISSN: 23256621 NLM ISO Abbreviation: Ann Am Thorac Soc Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : American Thoracic Society, [2013]- |
| مواضيع طبية MeSH: | Hypertension, Pulmonary*/epidemiology , Hypertension, Pulmonary*/therapy , Hypertension, Pulmonary*/etiology , Pulmonary Arterial Hypertension*/complications, Adult ; Humans ; United States/epidemiology ; Familial Primary Pulmonary Hypertension ; Proportional Hazards Models ; Registries |
| مستخلص: | Rationale: Pulmonary arterial hypertension (PAH) is a heterogeneous disease within a complex diagnostic and treatment environment. Other complex heart and lung diseases have substantial regional variation in characteristics and outcomes; however, this has not been previously described in PAH. Objectives: To identify baseline differences between U.S. census regions in the characteristics and outcomes for participants in the Pulmonary Hypertension Association Registry (PHAR). Methods: Adults with PAH were divided into regional groups (Northeast, South, Midwest, and West), and baseline differences between census regions were presented. Kaplan-Meier survival analyses and Cox proportional hazards were used to estimate the association between region and mortality in unadjusted and adjusted models. Results: Substantial differences by census regions were seen in age, race, ethnicity, marital status, employment, insurance payor breakdown, active smoking, and current alcohol use. Differences were also seen in PAH etiology and baseline 6-minute walk distance test results. Treatment characteristics varied by census region, and mortality appeared to be lower in PHAR participants in the West (hazard ratio, 0.60; 95% confidence interval, 0.43-0.83, P = 0.005). This difference was not readily explained by differences in demographic characteristics, PAH etiology, baseline severity, baseline medication regimen, or disease prevalence. Conclusions: The present study suggests significant regional variation among participants at accredited pulmonary vascular disease centers in multiple baseline characteristics and mortality. This variation may have implications for clinical research planning and represent an important focus for further study to better understand whether there are remediable care aspects that can be addressed in the pursuit of providing equitable care in the United States. |
| References: | Ann Am Thorac Soc. 2021 Apr;18(4):613-622. (PMID: 33064950) Ann Am Thorac Soc. 2021 Apr;18(4):584-585. (PMID: 33792520) Cureus. 2022 Nov 21;14(11):e31764. (PMID: 36569732) Pulm Circ. 2022 Jan 18;12(1):e12020. (PMID: 35506069) Eur Respir J. 2021 Feb 25;57(2):. (PMID: 33243844) Chest. 2017 Apr;151(4):749-754. (PMID: 27818333) Ann Am Thorac Soc. 2022 Sep;19(9):1459-1468. (PMID: 35239467) J Am Heart Assoc. 2023 Jan 17;12(2):e026940. (PMID: 36625296) J Pediatr. 2016 Mar;170:246-52.e1-4. (PMID: 26690850) Chest. 2021 Sep;160(3):843-853. (PMID: 33878343) Eur Heart J. 2022 Oct 11;43(38):3618-3731. (PMID: 36017548) Pulm Circ. 2022 Jul 01;12(3):e12120. (PMID: 35911181) Cancer Epidemiol Biomarkers Prev. 2012 Jul;21(7):1012-8. (PMID: 22564868) Eur Heart J. 2016 Jan 1;37(1):67-119. (PMID: 26320113) Soc Sci Med. 2015 Dec;147:121-5. (PMID: 26560411) Arch Intern Med. 2001 Oct 22;161(19):2351-5. (PMID: 11606151) Chest. 2019 Mar;155(3):565-586. (PMID: 30660783) Circulation. 2009 Feb 3;119(4):597-605. (PMID: 19188520) N Engl J Med. 2010 Jul 1;363(1):45-53. (PMID: 20463332) Diseases. 2022 Jan 07;10(1):. (PMID: 35076491) JAMA Intern Med. 2013 May 27;173(10):887-93. (PMID: 23568223) Chest. 2021 Jan;159(1):337-346. (PMID: 32882243) Anesthesiology. 2015 Nov;123(5):997-1012. (PMID: 26291778) |
| معلومات مُعتمدة: | R01 HL152724 United States HL NHLBI NIH HHS; R01HL152724 United States HL NHLBI NIH HHS |
| فهرسة مساهمة: | Keywords: epidemiology; pulmonary vascular disease; regional variation; social determinants of health |
| تواريخ الأحداث: | Date Created: 20230908 Date Completed: 20231204 Latest Revision: 20231218 |
| رمز التحديث: | 20231218 |
| مُعرف محوري في PubMed: | PMC10704225 |
| DOI: | 10.1513/AnnalsATS.202305-424OC |
| PMID: | 37683277 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2325-6621 |
|---|---|
| DOI: | 10.1513/AnnalsATS.202305-424OC |