Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service
Objectives This study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH).Design Retrospecti...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/1/e080068.full |
| _version_ | 1826805575917240320 |
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| author | David G Kiely Iain Armstrong Robin Condliffe Andrew J Swift Allan Lawrie Rafael Sauter Jim Wild Athanasios Charalampopoulos Alex Rothman Abdul Hameed Smitha Rajaram Judith Hurdman Catherine Billings Charlie Elliot AA Roger Thompson Robert A Lewis Lisa Watson Neil Hamilton Steven Wood Charlotte Durrington Fernando Exposto Ruvimbo Muzwidzwa Louise Raiteri Amélie Beaudet Audrey Muller Nadia Pillai Rehan Quadery |
| author_facet | David G Kiely Iain Armstrong Robin Condliffe Andrew J Swift Allan Lawrie Rafael Sauter Jim Wild Athanasios Charalampopoulos Alex Rothman Abdul Hameed Smitha Rajaram Judith Hurdman Catherine Billings Charlie Elliot AA Roger Thompson Robert A Lewis Lisa Watson Neil Hamilton Steven Wood Charlotte Durrington Fernando Exposto Ruvimbo Muzwidzwa Louise Raiteri Amélie Beaudet Audrey Muller Nadia Pillai Rehan Quadery |
| author_sort | David G Kiely |
| collection | DOAJ |
| description | Objectives This study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH).Design Retrospective observational study.Setting Pulmonary hypertension referral centre in the UK.Participants Adults diagnosed with CTEPH between 1 January 2012 and 30 June 2019 were included. Cohorts were retrospectively defined for operated patients (received pulmonary endarterectomy (PEA)) and not operated; further subgroups were defined based on risk score (low, intermediate or high risk for 1-year mortality) at diagnosis.Primary and secondary outcome measures Demographics, clinical characteristics, comorbidities, treatment patterns, HRQoL, HCRU, costs and survival outcomes were analysed.Results Overall, 683 patients were analysed (268 (39%) operated; 415 (61%) not operated). Most patients in the operated and not-operated cohorts were intermediate risk (63%; 53%) or high risk (23%; 31%) at diagnosis. Intermediate-risk and high-risk patients had higher HCRU and costs than low-risk patients. Outpatient and accident and emergency visits were lower postdiagnosis for both cohorts and all risk groups versus prediagnosis. HRQoL scores noticeably improved in the operated cohort post-PEA, and less so in the not-operated cohort at 6–18 months postdiagnosis. Survival at 5 years was 83% (operated) and 49% (not operated) and was lower for intermediate-risk and high-risk patients compared with low-risk patients.Conclusions Findings from this study support that risk assessment at diagnosis is prognostic for mortality in patients with CTEPH. Low-risk patients have better survival and HRQoL and lower HCRU and costs compared with intermediate-risk and high-risk patients. |
| first_indexed | 2024-03-07T21:52:10Z |
| format | Article |
| id | doaj.art-3993aaf4b13943c7be76f4d6a5b3da06 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2025-03-17T02:12:38Z |
| publishDate | 2024-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-3993aaf4b13943c7be76f4d6a5b3da062025-02-13T01:35:09ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-080068Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral serviceDavid G Kiely0Iain ArmstrongRobin CondliffeAndrew J SwiftAllan Lawrie1Rafael Sauter2Jim WildAthanasios CharalampopoulosAlex RothmanAbdul HameedSmitha RajaramJudith HurdmanCatherine BillingsCharlie ElliotAA Roger ThompsonRobert A LewisLisa WatsonNeil Hamilton3Steven Wood4Charlotte Durrington5Fernando Exposto6Ruvimbo Muzwidzwa7Louise Raiteri8Amélie Beaudet9Audrey Muller10Nadia Pillai11Rehan QuaderyDivision of Clinical Medicine, University of Sheffield, Sheffield, UKDivision of Clinical Medicine, University of Sheffield, Sheffield, UKActelion Pharmaceuticals Ltd, Allschwil, SwitzerlandSheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UKNIHR Biomedical Research Centre Sheffield, Sheffield, UKSheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UKIQVIA, London, UKIQVIA, London, UKIQVIA, London, UKActelion Pharmaceuticals Ltd, Allschwil, SwitzerlandActelion Pharmaceuticals Ltd, Allschwil, SwitzerlandActelion Pharmaceuticals Ltd, Allschwil, SwitzerlandObjectives This study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH).Design Retrospective observational study.Setting Pulmonary hypertension referral centre in the UK.Participants Adults diagnosed with CTEPH between 1 January 2012 and 30 June 2019 were included. Cohorts were retrospectively defined for operated patients (received pulmonary endarterectomy (PEA)) and not operated; further subgroups were defined based on risk score (low, intermediate or high risk for 1-year mortality) at diagnosis.Primary and secondary outcome measures Demographics, clinical characteristics, comorbidities, treatment patterns, HRQoL, HCRU, costs and survival outcomes were analysed.Results Overall, 683 patients were analysed (268 (39%) operated; 415 (61%) not operated). Most patients in the operated and not-operated cohorts were intermediate risk (63%; 53%) or high risk (23%; 31%) at diagnosis. Intermediate-risk and high-risk patients had higher HCRU and costs than low-risk patients. Outpatient and accident and emergency visits were lower postdiagnosis for both cohorts and all risk groups versus prediagnosis. HRQoL scores noticeably improved in the operated cohort post-PEA, and less so in the not-operated cohort at 6–18 months postdiagnosis. Survival at 5 years was 83% (operated) and 49% (not operated) and was lower for intermediate-risk and high-risk patients compared with low-risk patients.Conclusions Findings from this study support that risk assessment at diagnosis is prognostic for mortality in patients with CTEPH. Low-risk patients have better survival and HRQoL and lower HCRU and costs compared with intermediate-risk and high-risk patients.https://bmjopen.bmj.com/content/14/1/e080068.full |
| spellingShingle | David G Kiely Iain Armstrong Robin Condliffe Andrew J Swift Allan Lawrie Rafael Sauter Jim Wild Athanasios Charalampopoulos Alex Rothman Abdul Hameed Smitha Rajaram Judith Hurdman Catherine Billings Charlie Elliot AA Roger Thompson Robert A Lewis Lisa Watson Neil Hamilton Steven Wood Charlotte Durrington Fernando Exposto Ruvimbo Muzwidzwa Louise Raiteri Amélie Beaudet Audrey Muller Nadia Pillai Rehan Quadery Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service BMJ Open |
| title | Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service |
| title_full | Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service |
| title_fullStr | Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service |
| title_full_unstemmed | Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service |
| title_short | Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service |
| title_sort | risk assessment and real world outcomes in chronic thromboembolic pulmonary hypertension insights from a uk pulmonary hypertension referral service |
| url | https://bmjopen.bmj.com/content/14/1/e080068.full |
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