Patient Age Linked With Specific PAH Clinical Profile and Prognosis

Elderly woman's hands in hospital room, IV drip, oxygen monitor
Elderly woman’s hands in hospital room, IV drip, oxygen monitor
Patients with pulmonary hypertension age ≥65 years have worse long-term survival compared with younger patients.

Patients with pulmonary hypertension age ≥65 years have worse long-term survival compared with younger patients, a difference likely reflective of a longer diagnosis delay and higher comorbidity burden in older patients, according to study results published in ERJ Open Research.

A total of 248 consecutive patients with pulmonary hypertension from a French regional referral center for pulmonary hypertension were included in the study. Patients enrolled in the study had precapillary pulmonary hypertension and were categorized as young (<65 years; n=101), elderly (65-74 years; n=82), and very elderly (≥75 years; n=65). Researchers compared groups for overall survival and sought to identify prognostic factors for mortality.

Elderly and very elderly patients had a longer time to diagnosis of pulmonary hypertension compared with younger patients (9±21 months and 16±32 months vs 7±48 months, respectively; P =.001). Compared with young and elderly patients, very elderly patients had a higher prevalence of comorbidities, including systemic arterial hypertension (P <.001), coronary artery disease (P =.05), and cardiac arrhythmias (P <.001).

Although overall survival was 46±1.4 months, elderly patients and very elderly patients had an overall survival of 37±4.9 months and 28±4.7 months, respectively. Factors associated with mortality in the univariate analysis included male sex, etiologic group 3 pulmonary hypertension, a 6-minute walking distance of <210 meters, and a history of chronic obstructive pulmonary dysfunction, stroke, or cognitive disorders.

Study limitations included its retrospective design, the use of patient data taken from a single center, and the heterogeneous patient population.

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According to the researchers, the difference between elderly and very elderly patients and younger patients with regard to long-term survival “is likely to be related to a longer delay in diagnosis and a higher burden of comorbidities.”

Reference

Ginoux M, Turquier S, Chebib N, et al. Impact of comorbidities and delay in diagnosis in elderly patients with pulmonary hypertension. ERJ Open Res. 2018;4(4).