Deprivation And Prognosis In Patients With Pulmonary Arterial Hypertension: Missing The Effect Of Deprivation On A Rare Disease?

In this journal, Pellino et al. presented survival analysis to assess how deprivation affects prognosis in patients with pulmonary arterial hypertension (PAH) [1]. Their conclusions were that social deprivation is not a significant referral barrier or prognostic factor for idiopathic (I)PAH or heritable (H)PAH in Scotland. This may appear surprising given the wider context of literature describing outcomes stratified by social deprivation. The authors were thorough on using both the address at time of diagnosis and at time of censoring to assign deprivation scores and compare the two, finding no significant differences between the two approaches. They also compared deprivation assigned to PAH cases to expected deprivation based on Scottish citizenry as a whole and found that PAH patients are more socially deprived than expected. Finally, they used the same survival univariate analysis adjusting for age and sex to assess how several clinical variables are associated with prognosis. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Sofianopoulou has nothing to disclose. Conflict of interest: Dr. Church has nothing to disclose. Conflict of interest: Dr. Coghlan reports grants and personal fees from Johnson u0026 Johnson, personal fees from Glaxo Smith Klein, personal fees from Bayer, personal fees from MSD, outside the submitted work. Conflict of interest: Dr. Howard has nothing to disclose. Conflict of interest: Dr. Johnson reports grants and personal fees from Actelion, grants and personal fees from MSD, outside the submitted work. Conflict of interest: Dr. Kiely has nothing to disclose. Conflict of interest: Dr. Lawrie reports grants from British Heart Foundataion, grants from Medical Research Council, grants, personal fees and other from Actelion Pharmaceuticals Ltd, grants and personal fees from GlaxoSmithKline, outside the submitted work. Conflict of interest: Dr. Lordan has nothing to disclose. Conflict of interest: Dr. Wilkins has nothing to disclose. Conflict of interest: Dr. Wort has nothing to disclose. Conflict of interest: Dr. Morrell has nothing to disclose. Conflict of interest: Dr. Toshner reports personal fees from GSK, grants and personal fees from Ju0026J/Actelion, grants from Merck, grants from Bayer, outside the submitted work.