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Risk Factors for Respiratory Failure in Patients Hospitalized With Systemic Sclerosis: An Analysis of the National
Amy Trang1, Soumyasri Kambhatla2, Augustine Manadan3
1Internal Medicine, Rush University Medical Center, Chicago, USA.
Cureus
|April 7, 2023
Summary
Systemic sclerosis patients hospitalized with heart failure, interstitial lung disease, pneumonia, or pulmonary hypertension face higher risks of respiratory failure. Identifying these factors can improve patient outcomes.
Area of Science:
- Pulmonary Medicine
- Rheumatology
- Critical Care Medicine
Background:
- Systemic sclerosis (SSc) poses a significant risk for respiratory failure in patients.
- Early identification of risk factors for respiratory failure is crucial for improving hospitalization outcomes in SSc patients.
Purpose of the Study:
- To investigate risk factors associated with developing respiratory failure in hospitalized Systemic sclerosis patients in the United States.
- To analyze a large, multi-year, population-based dataset to identify predictors of respiratory failure in SSc hospitalizations.
Main Methods:
- Retrospective study of SSc hospitalizations from 2016-2019 using the US National Inpatient Sample database.
- Multivariate logistic regression analysis to determine adjusted odds ratios (ORadj) for respiratory failure.
- Comparison of SSc hospitalizations with and without a principal diagnosis of respiratory failure (3,930 vs. 94,910).
Main Results:
- Charlson comorbidity index (ORadj = 1.05), heart failure (ORadj = 1.81), interstitial lung disease (ILD) (ORadj = 3.62), pneumonia (ORadj = 3.40), pulmonary hypertension (ORadj = 3.59), and smoking (ORadj = 1.42) were significantly associated with respiratory failure.
- Patients with respiratory failure exhibited higher in-hospital mortality compared to those without it.
- This study analyzed the largest sample to date for risk factors of respiratory failure in SSc inpatients.
Conclusions:
- Key risk factors for inpatient respiratory failure in Systemic sclerosis patients include Charlson comorbidity index, heart failure, ILD, pulmonary hypertension, smoking, and pneumonia.
- Recognizing and managing these risk factors during outpatient and inpatient care can enhance hospitalization outcomes for SSc patients.
- Improved management strategies targeting identified risk factors may reduce mortality in SSc patients experiencing respiratory failure.
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