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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Hospitalizations and mortality in systemic sclerosis: results from the Nationwide Inpatient Sample
L Chung1, E Krishnan, E F Chakravarty
1Division of Immunology and Rheumatology, Stanford University, Stanford, CA, USA. shauwei@stanford.edu
Rheumatology (Oxford, England)
|November 8, 2007
Summary
Systemic sclerosis (SSc) hospitalizations are more common in women but less deadly. Pulmonary fibrosis significantly increases SSc patient mortality and length of hospital stay, highlighting the need for better treatments.
Area of Science:
- Rheumatology
- Pulmonology
- Healthcare Outcomes Research
Background:
- Systemic sclerosis (SSc) is a complex autoimmune disease with significant morbidity and mortality.
- Understanding contemporary hospitalization patterns and outcomes is crucial for improving patient care.
- Identifying predictors of adverse events can guide clinical management and research priorities.
Purpose of the Study:
- To investigate the primary causes of hospitalization for systemic sclerosis (SSc) in the United States.
- To identify key predictors of adverse outcomes, including in-hospital mortality and length of stay, among hospitalized SSc patients.
- To analyze contemporary hospitalization trends in SSc using large-scale administrative data.
Main Methods:
- Utilized the 2002-2003 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) databases.
- Identified SSc hospitalizations (ICD9-CM code 710.1), excluding patients with lupus or rheumatoid arthritis.
- Calculated hospitalization rates, in-hospital mortality, and mean length of stay (LOS), employing multivariate logistic and linear regression for outcome prediction.
Main Results:
- The overall in-hospital mortality rate was 6.3%, with an average length of stay of 6.6 days.
- Women exhibited 4.5 times higher hospitalization rates but a 25% lower in-hospital mortality compared to men.
- Pulmonary fibrosis was the most common secondary diagnosis (24%) and a significant predictor of increased in-hospital death (OR 2.63) and LOS.
Conclusions:
- Women with SSc experience higher hospitalization rates but better in-hospital survival than men.
- Pulmonary fibrosis emerges as a critical determinant of poor outcomes in SSc hospitalizations.
- Further development of targeted therapies for pulmonary fibrosis in SSc is essential to reduce mortality.