Tektonidou Maria G, Wang Zhong, Dasgupta Abhijit, Ward Michael M
University of Athens, Athens, Greece.
National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland.
Arthritis Care Res (Hoboken). 2015 Aug;67(8):1078-85. doi: 10.1002/acr.22575.
To compare rates of hospitalization for serious infections, trends in rates from 1996 to 2011, and in-hospital mortality between patients with systemic lupus erythematosus (SLE) and those without SLE in a national sample.
We analyzed hospitalizations for pneumonia, bacteremia/sepsis, urinary tract infections, skin infections, and opportunistic infections among adults in the Nationwide Inpatient Sample. We compared rates of hospitalization yearly among patients with SLE and the general population. We also computed odds ratios (ORs) for in-hospital mortality.
In 1996, the estimated number of hospitalizations for pneumonia in patients with SLE was 4,382, followed by sepsis (2,305), skin infections (1,422), urinary tract infections (643), and opportunistic infections (370). Rates were much higher in patients with SLE than in those without SLE, with age-adjusted relative risks ranging from 5.7 (95% confidence interval [95% CI] 5.5-6.0) for pneumonia to 9.8 (95% CI 9.1-10.7) for urinary tract infection in 1996. Risks increased over time, so that by 2011, all relative risks exceeded 12.0. Overall risk of in-hospital mortality was higher in SLE only for opportunistic infections (adjusted OR 1.52 [95% CI 1.12-2.07]). However, in pneumonia and sepsis, mortality risks were higher in SLE among those who required mechanical ventilation.
Hospitalization rates for serious infections in SLE increased substantially between 1996 and 2011, reaching over 12 times higher than in patients without SLE in 2011. Reasons for this acceleration are unclear. In-hospital mortality was higher among patients with SLE and opportunistic infections and those with pneumonia or sepsis who required mechanical ventilation.
在全国样本中比较系统性红斑狼疮（SLE）患者和非SLE患者严重感染的住院率、1996年至2011年期间住院率的变化趋势以及住院死亡率。
我们分析了全国住院患者样本中成年人肺炎、菌血症/败血症、尿路感染、皮肤感染和机会性感染的住院情况。我们比较了SLE患者和普通人群每年的住院率。我们还计算了住院死亡率的比值比（OR）。
1996年，SLE患者肺炎的估计住院人数为4382例，其次是败血症（2305例）、皮肤感染（1422例）、尿路感染（643例）和机会性感染（370例）。SLE患者的发病率远高于非SLE患者，1996年年龄调整后的相对风险范围从肺炎的5.7（95%置信区间[95%CI]5.5 - 6.0）到尿路感染的9.8（95%CI 9.1 - 10.7）。风险随时间增加，到2011年，所有相对风险均超过12.0。仅在机会性感染方面，SLE患者的总体住院死亡风险更高（调整后的OR为1.52[95%CI 1.12 - 2.07]）。然而，在肺炎和败血症方面，需要机械通气的SLE患者的死亡风险更高。
1996年至2011年期间，SLE患者严重感染的住院率大幅上升，2011年比非SLE患者高出12倍以上。这种加速上升的原因尚不清楚。SLE患者以及患有机会性感染、肺炎或败血症且需要机械通气的患者的住院死亡率更高。
