Mortality and In-Patient Outcomes in Pheochromocytoma Patients with Hypertensive Emergency in the United States: A Propensity Score Matched Analysis

Margaret A Roth; Katarina Leyba; Ishan Garg; Wilfredo H Madrid; Mohammed A Quazi; Amir H Sohail; Rozi Khan; Sulaiman Sultan; Abu Baker Sheikh

doi:10.1016/j.cpcardiol.2024.102578

Mortality and In-Patient Outcomes in Pheochromocytoma Patients with Hypertensive Emergency in the United States: A Propensity Score Matched Analysis

Curr Probl Cardiol. 2024 Apr 22:102578. doi: 10.1016/j.cpcardiol.2024.102578. Online ahead of print.

Authors

Margaret A Roth¹, Katarina Leyba², Ishan Garg¹, Wilfredo H Madrid³, Mohammed A Quazi⁴, Amir H Sohail⁵, Rozi Khan⁶, Sulaiman Sultan⁷, Abu Baker Sheikh⁸

Affiliations

¹ Department of Internal Medicine, University of New Mexico, Albuquerque NM, 87113, USA.
² Department of Internal Medicine, University of Colorado, Aurora, CO 80045, USA.
³ Department of Cardiology, University of New Mexico, Albuquerque NM, 87113, USA.
⁴ Department of Biostatistics and Mathematics, University of New Mexico, Albuquerque NM, 87113, USA.
⁵ Department of Surgical Oncology, University of New Mexico, Albuquerque NM, 87113, USA.
⁶ Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
⁷ Department of Nephrology, University of New Mexico, Albuquerque NM, 87113, USA.
⁸ Department of Internal Medicine, University of New Mexico, Albuquerque NM, 87113, USA. Electronic address: absheikh@salud.unm.edu.

PMID: 38657719
DOI: 10.1016/j.cpcardiol.2024.102578

Abstract

Introduction: Pheochromocytoma is a rare cause of hypertensive emergency. The objective of this analysis was to compare the clinical characteristics, comorbidities, and in-hospital outcomes of patients admitted with hypertensive emergencies with and without co-existing pheochromocytoma.

Methods: A retrospective analysis of the National Inpatient Sample (NIS) Database from 2016 to 2020 was conducted, encompassing 640,395 patients hospitalized for hypertensive emergencies, including 2,535 patients diagnosed with pheochromocytoma. We compared demographics, comorbidities, in-hospital outcomes and resource utilization metrics in patients with and without pheochromocytoma. Propensity-score matching was utilized to account for potential confounders and risk of complications was compared.

Results: Among the pheochromocytoma cohort (51.9% female), a significant portion (35.7%) were under 50 years of age, with the majority being Caucasian (47.9%). Comorbid conditions such as obesity, diabetes, and smoking were prevalent, with notable differences in cancer (7.5% vs. 2.3%, p<0.001) and peripheral vascular disease (17% vs. 8.2%, p<0.001) rates compared to the non-pheochromocytoma cohort. Pheochromocytoma patients had a longer hospital stay (7.5 vs. 6 days, p = 0.002) and higher odds of acute kidney injury (AKI) (1.54, 1.18-2, p=0.001) but lower odds of requiring hemodialysis (0.52, 0.32-0.79, p<0.001) or experiencing major cardiovascular events (0.5, 0.36-0.69, p<0.001). No significant difference in inflation-adjusted hospitalization costs was found between the groups.

Conclusions: Patients with hypertensive emergencies and pheochromocytoma had a higher incidence of AK, certain comorbidities (cancer, peripheral vascular disease), and more complex hospital courses suggested by longer length of stay. However, the overall cost of hospitalization did not significantly differ between the two cohorts.

Keywords: Hypertensive emergency; National Inpatient Sample (NIS); inpatient mortality; pheochromocytoma.

Publication types

Review