Garry Lachhar, MD
Resident Physician
Stony Brook Southampton Hospital
Southampton, NY
Disclosure information not submitted.
Parker Lavigne, MD
Dr. Parker Lavigne
HonorHealth, United States
Disclosure information not submitted.
Elnaz Mahbub, DO,
Resident Physician
Stony Brook Southampton Hospital
Southampton, NY
Disclosure information not submitted.
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Krishna Akella, DO
Dr. Krishna Akella
HonorHealth, United States
Disclosure information not submitted.
Therese Sargent, NP
Therese Sargent, NP
HonorHealth, United States
Disclosure information not submitted.
Title: Psychiatric Disease Characterization of Pulmonary Hypertension by WHO Classification
Introduction: Pulmonary Hypertension (PH) is a heterogeneous group of disorders resulting in progressive right heart failure. Although association with psychiatric illness is known to exist, profiles to better understand individual risk based on WHO classification remain poorly defined. At our teaching institution, we sought to evaluate the association between psychiatric illness and PH.
Methods: A composite database of National Inpatient Sample (NIS) for 2016 and 2017 was queried using ICD-10 codes to identify patients with PH subdivided by the WHO classification. Group 1 PH (PAH) was further subcategorized into primary and secondary. A propensity weighted logistic regression analysis was performed controlling for age, gender, substance abuse (opioid, stimulants, cocaine, hallucinogen, alcohol, cannabis, sedative anxiolytic), family history of psychiatric illness, history of abuse, history of psychiatric trauma and medical comorbidities (presence of AICD, pacemaker, history of chronic heart failure, diabetes, ischemic stroke, COPD, PVD, CKD, OSA, hypertension, CAD). Cohorts were compared for correlation with psychiatric illnesses including: attention deficit hyperactivity disorder, major depressive disorder (recurrent or single episode), bipolar disorder, generalized anxiety disorder, schizophrenia, obsessive compulsive disorder, post-traumatic stress disorder, panic disorder, personality disorders (obsessive compulsive, borderline, antisocial, composite), bulimia, anorexia nervosa, and brief psychotic disorder.
Results: A study cohort with 56,211 hospitalizations was evaluated, made up of a composite of patients with PH. Average age was 70.10+ 0.13 years, of whom 59.12% were female. A propensity weighted logistic regression model using each psychiatric illness category as a dependent variable was performed using Stata 17.0. Using a Bonferroni correction for 22 variables, a p value threshold of 0.0022 was used. Primary PAH was found to be strongly associated with obsessive compulsive personality disorder. Group 3 PH was found to be strongly associated with bulimia and anorexia nervosa. Group 4 PH was strongly associated with borderline personality disorder and brief psychotic disorder.
Conclusions: Clinicians should have a high index of suspicion for concurrent psychiatric illness in at risk subgroups of PH.