Increasing Incidence and Prevalence of World Health Organization Groups 1 to 4 Pulmonary Hypertension A Population-Based Cohort Study in Ontario, Canada
Increasing Incidence and Prevalence of World Health Organization Groups 1 to 4 Pulmonary Hypertension A Population-Based Cohort Study in Ontario, Canada
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DOI：
10.1161/circoutcomes.117.003973
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发表时间：
2018-02-01
影响因子：
6.9
通讯作者：
Archer, Stephen L.
中科院分区：
文献类型：
--
作者：
Wijeratne, D. Thiwanka;Lajkosz, Katherine;Archer, Stephen L.
背景：世界卫生组织将肺动脉高压（PH）分为 5 类，按发病机制或合并症分类：1-肺动脉高压；2-左心疾病；3-肺部疾病和缺氧；4-慢性血栓栓塞性疾病；5-杂项。除第 1 组外，肺结核的流行病学在很大程度上是未知的。方法和结果：我们描述了 1993 年至 2012 年第 1 至 4 组肺结核的发病率、患病率、合并症、死亡率和处方模式。病例定义基于住院和急诊科就诊情况，使用临床评估科学研究所的数据，该数据包括安大略省居民全民覆盖医疗服务记录的链接数据库。该队列包括 50 529 名 PH 患者。从2003年到2012年，成人PH的年发病率从24.1例/10万人口增加到28.7例/10万人口，年患病率从1993年到2012年从99.8例/10万人口增加到127.3例/10万人口。成人 PH 最常见的形式是第 2 组，单独出现（34.2%）或与第 3 组 PH 合并（29.3%）。 PH 的诊断使 1 年标准化死亡率增加 7.2 倍。成人 PH 患者的 30 天、1 年和 5 年死亡率分别为 13.0%、36.4% 和 62.4%。第 2 组和第 3 组死亡率最高，第 1 组最低。仅 3.6% 的左心疾病患者、0.7% 的肺部疾病患者和 1.4% 的血栓栓塞性疾病患者出现 PH，这表明 PH 是这些常见疾病相对罕见的并发症。儿童（年龄
BACKGROUND: The World Health Organization recognizes 5 groups of pulmonary hypertension (PH), categorized by pathogenesis or comorbidity: 1-pulmonary arterial hypertension 2-left-heart disease, 3-lung disease and hypoxia 4-chronic thromboembolic disease, and 5-miscellaneous. The epidemiology of PH, apart from group 1, is largely unknown.METHODS AND RESULTS: We describe incidence, prevalence, comorbidities, mortality and prescribing patterns for groups 1 to 4 PH from 1993 to 2012. Case definitions are based on hospitalizations and emergency department visits, using the Institute for Clinical Evaluative Sciences data, which comprises linked databases of universal coverage health service records for Ontario residents. This cohort included 50 529 patients with PH. The annual incidence of adult PH increased from 2003 to 2012 from 24.1 to 28.7 cases/100 000 population and the annual prevalence from 1993 to 2012 from 99.8 to 127.3 cases/100 000 population, respectively. The most common form of adult PH was group 2, alone (34.2%) or combined with group 3 PH (29.3%). A diagnosis of PH increased the 1-year standardized mortality ratio 7.2-fold. Mortality in adults with PH was 13.0%, 36.4%, and 62.4%, at 30 days, 1 year, and 5 years, respectively. Mortality was highest in groups 2 and 3 and lowest in group 1. PH was present in only 3.6% of people with left heart disease, 0.7% with lung disease, and 1.4% with thromboembolic disease, suggesting that PH is a relatively rare complication of these common diseases. Children (age