To understand the incidence and changing trend of the local pulmonary vascular diseases, and to lay a foundation for prevention and control strategy of the disease by analyzing the variety of the causes of the severe pulmonary vascular disease and the classification of the pulmonary hypertension in the comprehensive hospital.
By consulting the hospital records system, from 2015 to 2018, a retrospective cohort study had been conducted to analyze the cases with severe pulmonary vascular diseases who were admitted from January 1, 2002 to December 31, 2015 in Peking University Shenzhen Hospital. The etiological classification of patients with pulmonary hypertension was supplemented on the basis of NICE international diagnostic criteria in 2013.
1) Within fourteen years, there were 1254 cases diagnosed with four types of pulmonary vascular diseases, accounting for 0.256% in 489564 inpatients of Shenzhen hospital. The cases were made of 67.15% of chronic pulmonary hypertension, 31.58% of acute pulmonary embolism, 0.96% of pulmonary vascular malformation, and 0.32% of pulmonary vascular tumors.
2) 842 patients with severe pulmonary hypertension accounted for 0.172% of hospitalized patients. In five groups of pulmonary hypertension, Group 2 accounted for 40.5% and ranked first. In the etiological analysis, valvular heart diseases, congenital heart disease, and connective tissue disease account for 30.5%, 21.02% and 13.18% respectively.
3) The absolute numbers of pulmonary vascular diseases and pulmonary hypertension increased year by year, and there was a significant difference between 2012-2015 and 2002-2011 (P<0.0001). In the subgroup analysis, the changing trend of pulmonary hypertension associated with valvular disease， and congenital heart disease was statistically significant (P<0.0001and P<0.003).
The incidence of severe pulmonary hypertension and severe pulmonary embolism were the top two among pulmonary vascular diseases in Shenzhen comprehensive tertiary care hospitals. Valvular disease, congenital heart disease and connective tissue disease related to pulmonary hypertension were the first three causes of severe pulmonary hypertension, which were also the key and difficult points in the prevention and treatment to pulmonary hypertension in comprehensive hospitals. The changes in the constituent ratio and the incidence of pulmonary vascular disease increased year by year, which were closely related to the effect of the clinical diagnosis and treatment model. The model of multi-disciplinary team on pulmonary vascular disease in the comprehensive hospital was helpful to promote rapidly the diagnosis and treatment ability.
Key Words Critical care medicine, pulmonary vascular disease, pulmonary hypertension, pulmonary embolism, constituent ratio