Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. Pulmonary hypertension (PH) was associated with a 15% increase in odds of prolonged hospitalization.

2. PH was associated with a 31% decrease in odds of routine home discharge.

3. There was no association between PH and in-hospital mortality, though males had 31% higher odds of dying in the hospital compared to females.

Evidence Rating Level: 3 (Average)

Systemic and pulmonary hypertension (PH) are known to be associated with cerebrovascular disease and risk factors for stroke. However, little is known about the impact of PH on acute ischemic stroke outcomes. This study aimed to investigate the association between PH and adverse in-hospital outcomes following acute ischemic stroke, as well as potential sex differences among this sample. Admissions data for acute ischemic stroke were retrieved from the US National Inpatient Sample between October 2015 and December 2017. A total of 1,106,045 (median [IQR] age = 72 [61 to 82] years, 50.41% female) participants were included in analyses. The median length of stay was 3 days (IQR 2 to 6). The 31,830 (2.88%) participants with PH, compared to those without PH, were significantly older (median age = 80, difference 9 years) and were more likely to be female (difference 14.67%). Participants with PH were more likely to have co-occurring atrial fibrillation (difference 32.25%). Participants with PH were also more likely to receive revascularization therapies such as intravenous thrombolysis and endovascular thrombectomy. PH was not found to be associated with in-hospital mortality (OR 0.96, 95% CI 0.86 to 1.09) but it was associated with increased odds of prolonged hospitalization of greater than four days (OR 1.15, 95% CI 1.09 to 1.22). PH was also associated with decreased odds of routine discharge for both males and females (OR 0.87, 95% CI 0.81 to 0.94). Compared to younger participants, older persons with PH were less likely to be discharged routinely (p = 0.028) and men with PH were 31% more likely to die while in the hospital than their female counterparts (p = 0.024). Overall, this study found that PH was not associated with in-hospital mortality, though factors such as gender impact these outcomes. Further, PH is associated with prolonged hospitalization (>4 days) and adverse discharge status.

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