Goss Louisa B, Ortiz Justin R, Okamura Daryl M, Hayward Kristen, Goss Christopher H
Department of Medicine, University of Washington, Seattle, Washington, United States of America.
Department of Medicine, University of Washington, Seattle, Washington, United States of America; Department of Global Health, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2015 Jun 18;10(6):e0128920. doi: 10.1371/journal.pone.0128920. eCollection 2015.
Systemic lupus erythematosus (SLE or lupus) is an autoimmune multisystem disease. While a complete understanding of lupus' origins, mechanisms, and progression is not yet available, a number of studies have demonstrated correlations between disease prevalence and severity, gender, and race. There have been few population based studies in the United States.
To assess temporal changes in demographics and hospital mortality of patients with lupus in Washington State from 2003 to 2011.
This study used data from the Healthcare Cost and Utilization Project (HCUP), a patient information database, and data from the Washington State census to study a group of patients in the state. Lupus hospitalizations were defined as any hospitalization with an ICD-9-CM diagnosis code for systemic lupus erythematosus. Regression analysis was used to assess the effect of calendar time on demographics and hospital outcomes.
There were a total of 18,905 patients in this study with a diagnostic code for lupus. The mean age of the group was 51.5 years (95% CI: 50.6-52.3) in 2003 and 51.3 years (95% CI: 50.6-52.0) in 2011. The population was 88.6% female. Blacks were 2.8 times more likely to have a lupus hospitalization than whites when compared to the Washington population. While hospital mortality decreased during this eight year period (3.12% in 2003 to 1.28% in 2011, p=0.001) hospital length of stay remained statistically unchanged at an average of 4.9 days during that eight year period. We found a significant decrease in annual hospital mortality over the study period [odds ratio(OR): 0.92 per year, 95% CI 0.88-0.96, P<0.001]. Hospital mortality was higher in males (2.6% male death to 1.8% female death).
In this large group of hospitalized lupus patients in Washington, hospital length of stay remained relatively stable over time but hospital mortality decreased by over 50% over the eight year study period.
系统性红斑狼疮（SLE或狼疮）是一种自身免疫性多系统疾病。虽然尚未完全了解狼疮的起源、机制和病程，但多项研究已证明疾病患病率与严重程度、性别和种族之间存在关联。美国基于人群的研究较少。
评估2003年至2011年华盛顿州狼疮患者的人口统计学和医院死亡率的时间变化。
本研究使用了医疗成本和利用项目（HCUP）（一个患者信息数据库）的数据以及华盛顿州人口普查数据来研究该州的一组患者。狼疮住院定义为任何具有国际疾病分类第九版临床修订本（ICD-9-CM）系统性红斑狼疮诊断代码的住院治疗。采用回归分析评估日历时间对人口统计学和医院结局的影响。
本研究共有18905例有狼疮诊断代码的患者。该组患者的平均年龄在2003年为51.5岁（95%置信区间：50.6 - 52.3），2011年为51.3岁（95%置信区间：50.6 - 52.0）。该人群中女性占88.6%。与华盛顿州总体人群相比，黑人患狼疮住院的可能性是白人的2.8倍。虽然在此八年期间医院死亡率有所下降（从2003年的3.12%降至2011年的1.28%，p = 0.001），但在此八年期间医院住院时间在统计学上保持不变，平均为4.9天。我们发现研究期间年度医院死亡率显著下降[优势比（OR）：每年0.92，95%置信区间0.
