Airway Anomalies Predict Risk of Pediatric Pulmonary Hypertension.

Abstract

Introduction: Pediatric pulmonary hypertension (PH) significantly contributes to morbidity and mortality due to the progressive nature of the disease in some subtypes, which leads to severe right heart failure, impaired oxygenation, and subsequent complications of chronic hypoxia, and side effects of long-term therapies. Associations between PH and airway anomalies in pediatric patients are complex and multifactorial. Better understanding of these associations will help identify which patients should receive screening for PH by multidisciplinary care teams (pediatric otolaryngology, cardiology, pulmonology).

Methods: A retrospective, observational, single institution, cross-sectional study was performed using inpatient and emergency department visit records and operating room reports from January 2021 to January 2023 of pediatric patients. Odds ratios and logistic regression were used to determine the association between PH and other cardiopulmonary anomalies.

Results: PH was associated with cardiac and airway anomalies (Odds ratio, 95% CI; 3.26, 1.01-10.5, p < 0.05; Logistic Regression, pseudo-R² = 0.440, p < 0.01), especially bronchopulmonary dysplasia (BPD), atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), chronic lung disease/respiratory failure (CLD), and Down Syndrome (DS).

Conclusion: Our findings demonstrate PH is highly co-morbid with other cardiopulmonary anomalies and provide an estimate of the risk of having a concurrent congenital disease and PH. Patients with multiple comorbidities are at high risk for developing PH and should receive screening for PH via coordinated care by multidisciplinary care teams. Our results, with further quantification at other sites, could help further development of PH screening guidelines.