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Hospitalizations in patients with systemic sclerosis: Differences between limited and diffuse cutaneous subtypes.

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Systemic sclerosis subtypes, limited and diffuse cutaneous, show similar hospitalization rates. However, diffuse systemic sclerosis patients are more frequently admitted for disease-related reasons, indicating distinct causes of hospitalization.

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Area of Science:

  • Rheumatology
  • Clinical Medicine
  • Scleroderma Research

Background:

  • Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by significant morbidity and mortality.
  • Existing literature lacks clarity on hospitalization rate differences between limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) subtypes.
  • Understanding these differences is crucial for targeted patient management and resource allocation.

Purpose of the Study:

  • To investigate and compare the rates of all-cause hospitalizations between lcSSc and dcSSc.
  • To identify potential differences in hospitalization patterns based on SSc subtype.
  • To analyze the primary reasons for hospitalization in each subtype.

Main Methods:

  • Prospective patient data collection via the European Scleroderma Trials and Research Group database.
  • Retrospective analysis of hospitalization data (total, acute, elective, infusion-related) for 140 SSc patients.
  • Inclusion criteria screening and data extraction from Waikato Hospital records.

Main Results:

  • The study included 140 patients: 84 lcSSc (60.0%), 40 dcSSc (28.6%), 3 SSc sine scleroderma (2.1%), and 13 overlap syndrome (9.3%).
  • Mean 12-month total hospitalizations were 0.9 (SD 3.0) for lcSSc vs. 1.7 (SD 3.0) for dcSSc (p=0.062).
  • Mean 12-month acute hospitalizations were 0.6 (SD 1.3) for lcSSc vs. 1.2 (SD 2.4) for dcSSc (p=0.061).
  • Patients with dcSSc were significantly more likely to be admitted for SSc-related reasons (p < 0.001).

Conclusions:

  • Hospitalization rates between lcSSc and dcSSc subtypes are broadly similar, with a trend towards higher total and acute admissions in dcSSc.
  • Significant differences exist in the underlying causes for hospitalization between the two main SSc subtypes.
  • These findings highlight the importance of considering SSc subtype when evaluating hospitalization patterns and disease impact.