Shortening Hospital Stay Is Feasible and Safe in Patients With Chronic Thromboembolic Pulmonary Hypertension Treated With Balloon Pulmonary Angioplasty

Mai Kimura, Takashi Kohno, Takashi Kawakami, Masaharu Kataoka, Takahiro Hiraide, Hidenori Moriyama, Sarasa Isobe, Toshimitsu Tsugu, Yuji Itabashi, Mitsushige Murata, Shinsuke Yuasa, Keiichi Fukuda

Research output: Contribution to journalArticle

Abstract

Background: There is no consensus on the length of hospital stay (LOHS) and post-interventional management after balloon pulmonary angioplasty (BPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We examined temporal trends with respect to LOHS and requirement for intensive care for BPA and their relationship with the incidence of BPA-related complications. Methods: From November 2012 to September 2017, a total of 123 consecutive patients with CTEPH who underwent BPA were enrolled (age: 66.0 [54.0 to 74.0], World Health Organization [WHO] functional class II/III/IV; 27/88/8). Patients were divided for analysis into 3 groups according to the date of their first BPA: early-, middle-, and late-phase groups. Results: Mean pulmonary arterial pressure decreased from 36.0 (29.0 to 45.0) to 20.0 (16.0 to 22.0) mm Hg after BPA (P < 0.001). The LOHS was 41.0 (31.0 to 54.0) days in total including all sessions and 6.6 (6.0 to 7.9) days/session. Despite no significant differences in age, baseline hemodynamics, and laboratory data among the 3 groups, there was a significant reduction in LOHS (7.9 [7.0 to 9.5], 6.5 [6.1 to 7.3], 6.0 [5.3 to 6.5] days/session, P < 0.001) and use of intensive/high care unit (100%, 93%, 46%, P < 0.001). The reduction in LOHS and intensive/high care unit use did not affect the occurrence of BPA-related complications. Conclusions: Increasing experience with BPA was associated with a reduction in LOHS and the use of intensive/high care unit, but no change was noted in the rate of BPA-related complications. These findings suggest that the reduction in both LOHS and use of the intensive care unit for BPA is feasible and does not jeopardize the safety of the procedure.

Original languageEnglish
Pages (from-to)193-198
Number of pages6
JournalCanadian Journal of Cardiology
Volume35
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

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Balloon Angioplasty
Pulmonary Hypertension
Length of Stay
Lung
Intensive Care Units
Critical Care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Shortening Hospital Stay Is Feasible and Safe in Patients With Chronic Thromboembolic Pulmonary Hypertension Treated With Balloon Pulmonary Angioplasty. / Kimura, Mai; Kohno, Takashi; Kawakami, Takashi; Kataoka, Masaharu; Hiraide, Takahiro; Moriyama, Hidenori; Isobe, Sarasa; Tsugu, Toshimitsu; Itabashi, Yuji; Murata, Mitsushige; Yuasa, Shinsuke; Fukuda, Keiichi.

In: Canadian Journal of Cardiology, Vol. 35, No. 2, 01.02.2019, p. 193-198.

Research output: Contribution to journalArticle

Kimura, Mai ; Kohno, Takashi ; Kawakami, Takashi ; Kataoka, Masaharu ; Hiraide, Takahiro ; Moriyama, Hidenori ; Isobe, Sarasa ; Tsugu, Toshimitsu ; Itabashi, Yuji ; Murata, Mitsushige ; Yuasa, Shinsuke ; Fukuda, Keiichi. / Shortening Hospital Stay Is Feasible and Safe in Patients With Chronic Thromboembolic Pulmonary Hypertension Treated With Balloon Pulmonary Angioplasty. In: Canadian Journal of Cardiology. 2019 ; Vol. 35, No. 2. pp. 193-198.
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abstract = "Background: There is no consensus on the length of hospital stay (LOHS) and post-interventional management after balloon pulmonary angioplasty (BPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We examined temporal trends with respect to LOHS and requirement for intensive care for BPA and their relationship with the incidence of BPA-related complications. Methods: From November 2012 to September 2017, a total of 123 consecutive patients with CTEPH who underwent BPA were enrolled (age: 66.0 [54.0 to 74.0], World Health Organization [WHO] functional class II/III/IV; 27/88/8). Patients were divided for analysis into 3 groups according to the date of their first BPA: early-, middle-, and late-phase groups. Results: Mean pulmonary arterial pressure decreased from 36.0 (29.0 to 45.0) to 20.0 (16.0 to 22.0) mm Hg after BPA (P < 0.001). The LOHS was 41.0 (31.0 to 54.0) days in total including all sessions and 6.6 (6.0 to 7.9) days/session. Despite no significant differences in age, baseline hemodynamics, and laboratory data among the 3 groups, there was a significant reduction in LOHS (7.9 [7.0 to 9.5], 6.5 [6.1 to 7.3], 6.0 [5.3 to 6.5] days/session, P < 0.001) and use of intensive/high care unit (100{\%}, 93{\%}, 46{\%}, P < 0.001). The reduction in LOHS and intensive/high care unit use did not affect the occurrence of BPA-related complications. Conclusions: Increasing experience with BPA was associated with a reduction in LOHS and the use of intensive/high care unit, but no change was noted in the rate of BPA-related complications. These findings suggest that the reduction in both LOHS and use of the intensive care unit for BPA is feasible and does not jeopardize the safety of the procedure.",
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AU - Kohno, Takashi

AU - Kawakami, Takashi

AU - Kataoka, Masaharu

AU - Hiraide, Takahiro

AU - Moriyama, Hidenori

AU - Isobe, Sarasa

AU - Tsugu, Toshimitsu

AU - Itabashi, Yuji

AU - Murata, Mitsushige

AU - Yuasa, Shinsuke

AU - Fukuda, Keiichi

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N2 - Background: There is no consensus on the length of hospital stay (LOHS) and post-interventional management after balloon pulmonary angioplasty (BPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We examined temporal trends with respect to LOHS and requirement for intensive care for BPA and their relationship with the incidence of BPA-related complications. Methods: From November 2012 to September 2017, a total of 123 consecutive patients with CTEPH who underwent BPA were enrolled (age: 66.0 [54.0 to 74.0], World Health Organization [WHO] functional class II/III/IV; 27/88/8). Patients were divided for analysis into 3 groups according to the date of their first BPA: early-, middle-, and late-phase groups. Results: Mean pulmonary arterial pressure decreased from 36.0 (29.0 to 45.0) to 20.0 (16.0 to 22.0) mm Hg after BPA (P < 0.001). The LOHS was 41.0 (31.0 to 54.0) days in total including all sessions and 6.6 (6.0 to 7.9) days/session. Despite no significant differences in age, baseline hemodynamics, and laboratory data among the 3 groups, there was a significant reduction in LOHS (7.9 [7.0 to 9.5], 6.5 [6.1 to 7.3], 6.0 [5.3 to 6.5] days/session, P < 0.001) and use of intensive/high care unit (100%, 93%, 46%, P < 0.001). The reduction in LOHS and intensive/high care unit use did not affect the occurrence of BPA-related complications. Conclusions: Increasing experience with BPA was associated with a reduction in LOHS and the use of intensive/high care unit, but no change was noted in the rate of BPA-related complications. These findings suggest that the reduction in both LOHS and use of the intensive care unit for BPA is feasible and does not jeopardize the safety of the procedure.

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