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Desai R, Gandhi Z, Shiza ST, Jain A, Koshiya H, Alli-Ramsaroop B, Akinsete AO, Wilson E, Rudra P, Sunith Vegesna MS, Bari M, Vyas A, Rizvi B, Surani S. Prevalence and impact of tobacco use disorder on in-hospital mortality in patients hospitalized with non-group 1 pulmonary hypertension: a nationwide propensity score-matched analysis, 2019. EXCLI J 2023; 22:1200-1210. [PMID: 38204965 PMCID: PMC10776876 DOI: 10.17179/excli2023-6409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/20/2023] [Indexed: 01/12/2024]
Abstract
Numerous studies indicated that patients with tobacco use disorder (TUD) are inversely associated with mortality in what is known as the smoker's paradox. However, limited studies have been conducted on the impact of TUD on the in-hospital mortality rates of patients with secondary pulmonary hypertension (PH, Non-Group 1 PH). Using the 2019 National Inpatient Sample, we identified PH and divided it into TUD and non-TUD to compare the comorbidities and in-hospital mortality between the two after 1:1 propensity-score matching. Of 1,129,440 PH hospitalizations, 12.1 % had TUD. After matching (n=133545, each group), TUD had lower median age (62 vs. 63), higher females (49 vs. 46.6 %), blacks (25.9 vs. 25.3 %), lower household income (40.8 vs. 32.7 %), Medicaid (22.4 vs. 14.8 %), non-elective (93.5 vs. 89.8 %), rural (9.3 vs. 6.7 %), urban non-teaching (17.2 vs 15.8 %) admissions. All CV comorbidities and other substance use were higher in TUD except CHF and valvular heart disease, TUD+ cohort and lower mortality (3.3 vs. 4.2 %, OR 0.78, p<0.001), higher routine discharges (53.8 vs. 51.3 %, p<0.001) and lower total charges ($47155 vs. 51909, p<0.001) than non-TUD. Although PH patients with TUD had a higher comorbidity burden, they had lower in-hospital mortality rates along with lower total charges of hospitalization, mandating real-world data to validate these results. See also the Graphical abstract(Fig. 1).
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Affiliation(s)
- Rupak Desai
- Department of Cardiology, VA Medical Center, Atlanta, GA
| | - Zainab Gandhi
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, PA/USA
| | - Saher taj Shiza
- Department of Internal Medicine, Lincoln Hospital, Bronx, NY/USA
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Philadelphia, PA/USA
| | - Hiren Koshiya
- Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL/USA
| | | | | | - Eko Wilson
- Department of Cardiology, Georgetown Public Hospital Corporation, Guyana
| | - Pranathi Rudra
- Department of Medicine, Gandhi Medical College, Secunderabad, Telangana, India
| | | | - Madiha Bari
- Department of Medicine, Nazareth Hospital, Philadelphia, PA, USA
| | - Ankit Vyas
- Department of Internal Medicine, Baptist Hospital of Southeast Texas, Beaumont, TX, USA
| | - Bisharah Rizvi
- Department of Pulmonary Medicine, UHS Southern California Medical Education Center, Temecula, CA/USA
| | - Salim Surani
- Department of Pulmonary and Critical Care, Texas A&M University, College Station, TX, USA
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