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Pulmonary Hypertension is not an Independent Risk Factor for Morbidity and Mortality in the Trauma Population

Recent studies have suggested that the presence of pulmonary hypertension (pHtn) on admission to the intensive care unit is an independent risk factor for mortality with one study estimating a 30 per cent mortality for patients with pulmonary hypertension requiring intensive care unit (ICU) admission and up to a 40 per cent 6-month mortality rate. 1 Patients who received cardiopulmonary resuscitation had a 100 per cent mortality rate. Actual rates of pulmonary hypertension are difficult to determine because few studies examine the pHtn rate in the general population. In patients who presented with previously undiagnosed chronic obstructive pulmonary disease, 19 per cent of these patients were found to have previously undiagnosed pHtn. 2 Studies have also shown that pHtn is an independent risk factor for poor outcome after surgery or severe stress 3 because it is associated with higher early and late mortality rates after heart surgery, adverse cardiac events, and postoperative systolic dysfunction in the left ventricle. Severe pHtn (defined as systolic pulmonary artery pressure [sPAP] greater than 60 mmHg) is associated with increased mortality, increased length of ICU stay, increased mechanical ventilation, increased inotropic support requirements, and increased renal/ hepatic/pericardial complications. The goal of this study is to evaluate the incidence of pHtn in the trauma population and to assess whether the presence of pHtn is a negative prognostic indicator for the trauma patient. Under Institutional Review Board approval, the records of all patients aged 18 to 80 years who were