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Deaths in pulmonary hypertension: US location trends
  1. Safi Khan1,
  2. Muhammad Z Khan1,
  3. Muhammad Shahzeb Khan1,
  4. Stephen Greene2,
  5. Muhammad Usman Khan1,
  6. Richard A Krasuski2,
  7. Haider J Warraich3 and
  8. Erin D Michos4
  1. 1Department of Medicine, West Virginia University, Morgantown, West Virginia, USA
  2. 2Cardiovascular Medicine, Duke University, Durham, North Carolina, USA
  3. 3Department of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
  4. 4Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Muhammad Z Khan, West Virginia University, Morgantown WV 26506, West Virginia, USA; ziaulislam87{at}gmail.com

http://dx.doi.org/10.1136/bmjspcare-2020-002254

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    Pulmonary hypertension (PH) is a major cause of morbidity and mortality.1 While recently there has been an emphasis on hospice care for serious illnesses,2 little is known about end-of-life in PH. Since location of death is important, we investigated demographic trends and predictors of location among persons dying with PH in the USA.

    We analysed the Mortality Multiple Cause-of-Death Public Use Record from the National Center for Health Statistics, which provides mortality data for all US deaths, merged with death certificate data from the Centers for Disease Control (CDC) and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (WONDER) database. We included natural deaths between 2004 and 2017 for which PH was identified as an underlying cause. This was defined as the disease or injury leading directly to death as entered by the physician on the death certificate. In multiple comorbidities (common in PH), underlying cause is determined by condition sequence on the certificate and associated selection rules and modifications.2 3 Records were queried to include age, ethnicity, …

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    Footnotes

    • Contributors SK: manuscript writing. MZK: manuscript writing and data analysis. MSK: manuscript writing. SG: critical review of manuscript. MUK: critical review of manuscript. RAK: critical review of manuscript. HJW: critical review of manuscript and study design. EDM: study design and critical review of manuscript. SK and MZK are primary coauthors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.