Location of Terminal Care in Pulmonary Hypertension

Death locations for individuals in the US is influenced by social factors. Pulmonary hypertension (PH) is an uncommon condition, with a substantial impact on morbidity and mortality. We evaluated the patterns in and impact of demographics on PH death locations in the US.

From 2005 to 2020, our study identified PH-related deaths through the CDC repository. Patient-level demographic data for the year 2019 were directly queried from the CDC. Locations of death were categorized into 4 groups, as follows: inpatient; outpatient and/or emergency room (ER); home; and hospice and/or nursing facilities. Linear regression models were used to assess trends in proportion of deaths across these locations. Multivariable logistic regression models examined the influence of demographics on the likelihood of death occurring in each location.

Between 2005 and 2020, a rise occurred in the proportion of deaths at home (β = 0.006, P < 0.001) and in hospice and/or nursing facilities (β = 0.005, P < 0.001). The odds of dying at home or in hospice and/or nursing facilities increased with age (P < 0.001). Male decedents were more likely than female decedents to die in an outpatient and/or ER setting (odds ratio [OR] 1.22, P = 0.047) and at home (OR 1.16, P = 0.005). Compared to White decedents, Black decedents had higher odds of death in the inpatient (OR 1.99, P < 0.001) and the outpatient and/or ER (OR 1.38, P = 0.007) settings, but lower odds of death at home (OR 0.63, P < 0.001) or in hospice and/or nursing facilities (OR 0.46, P < 0.001).

Our analysis revealed a significant difference in the locations of death for patients with PH in recent years, as influenced by demographic factors.