Evidence map›Paper›PMID 37024760›Full record

ArticleAdvances in therapy2023

Predicting Risk of 1-Year Hospitalization Among Patients with Pulmonary Arterial Hypertension.

Chang Zhang, Yuen Tsang, Jinghua He, Sumeet Panjabi

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Article in Advances in therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Chang ZhangJanssen Business Technology Commercial Data Sciences, Titusville, NJ, USA.
Yuen TsangReal World Value & Evidence, Janssen Scientific Affairs, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA. ytsang@ITS.JNJ.com.
Jinghua HeReal World Research, Janssen Scientific Affairs, LLC, Titusville, NJ, USA.
Sumeet PanjabiReal World Value & Evidence, Janssen Scientific Affairs, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionUS claims-based analyses emphasize the substantial hospitalization burden of patients with pulmonary arterial hypertension (PAH) and the significant need for improved monitoring and more timely interventions. A claims-based predictive model may be useful to assist healthcare providers and payers in identifying patients with PAH at increased hospitalization risk. To address this aim, we constructed statistical models using baseline patient variables available in administrative healthcare claims to predict patients' risk for all-cause and PH-related hospitalization within 1 year of initiating ≥ 1 PAH indicated medication.

methodsAdult patients with PAH who newly initiated ≥ 1 PAH indicated medication were selected from the MarketScan Commercial and Medicare Supplemental databases (January 1, 2009-January 31, 2019). Cox regression models were built with a randomly selected training set and evaluated using a validation set of remaining patients. Predictive variables for the models were selected in three steps: clinical knowledge, univariate analysis, and backward stepwise selection.

resultsWithin 1 year of initiating ≥ 1 PAH indicated medication, 1502/3872 (38.8%) had an all-cause hospitalization and 950/3872 (24.5%) had a pulmonary hypertension (PH)-related hospitalization. Predictive risk factors for all-cause hospitalization were Quan-Charlson Comorbidity Index (CCI) score 2-3 [hazard ratio (HR) 1.229; P = 0.038] and ≥ 4 (HR 1.531; P < 0.001), claims-based frailty index (CFI) score > 1 (highest frailty level; HR 1.301; P = 0.018), hemoptysis (HR 1.254; P = 0.016), malaise/fatigue (HR 1.150; P = 0.037), history of PH-related hospitalization (HR 1.171; P = 0.011), non-PH-related ER visit (HR 1.713; P = 0.014), and higher non-PH-related outpatient visit cost (HR 1.069; P < 0.001). Predictive risk factors for PH-related hospitalization were female sex (HR 1.264; P = 0.004), Quan-CCI score ≥ 4 (HR 1.408; P = 0.008), portal hypertension (HR 1.565; P = 0.019), CFI score > 1 (HR 1.522; P = 0.002), dyspnea (HR 1.259; P = 0.023), and history of PH-related hospitalization (HR 1.273; P = 0.002).

conclusionsThe US claims-based predictive models showed acceptable performance to predict 1-year hospitalization among patients with PAH.

Indexed as

FrailtyHypertension, PulmonaryPulmonary Arterial HypertensionAdultAgedFemaleHospitalizationHumansMaleMedicareRetrospective StudiesUnited StatesHealthcare resource utilizationHospitalizationPatient characteristicsPredictive risk factorsPulmonary arterial hypertension

Identifiers

PMID37024760
PMCPMC10079144

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.