Yeh Jun-Jun, Wang Yu-Chiao, Chen Jiunn-Horng, Hsu Wu-Huei
Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.
Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
PLoS One. 2016 Sep 21;11(9):e0163382. doi: 10.1371/journal.pone.0163382. eCollection 2016.
We conducted a nationwide cohort study to investigate the relationship between systemic lupus erythematosus (SLE) and the risk of incident respiratory failure.
From the National Health Insurance Research Database, we identified 11 533 patients newly diagnosed with SLE and 46 132 controls without SLE who were randomly selected through frequency-matching according to age, sex, and index year. Both cohorts were followed until the end of 2011 to measure the incidence of incident respiratory failure, which was compared between the 2 cohorts through a Cox proportional hazards regression analysis.
The adjusted hazard ratio (aHR) of incident respiratory failure was 5.80 (95% confidence interval [CI] = 5.15-6.52) for the SLE cohort after we adjusted for sex, age, and comorbidities. Both men (aHR = 3.44, 95% CI = 2.67-4.43) and women (aHR = 6.79, 95% CI = 5.93-7.77) had a significantly higher rate of incident respiratory failure in the SLE cohort than in the non-SLE cohort. Both men and women aged <35 years (aHR = 31.2, 95% CI = 21.6-45.2), 35-65 years; (aHR = 6.19, 95% CI = 5.09-7.54) and ≥65 years (aHR = 2.35, 95% CI = 1.92-2.87) had a higher risk of incident respiratory failure in the SLE cohort. Moreover, the risk of incident respiratory failure was higher in the SLE cohort than the non-SLE cohort, for subjects with (aHR = 2.65, 95% CI = 2.22-3.15) or without (aHR = 9.08, 95% CI = 7.72-10.7) pre-existing comorbidities. In the SLE cohort, subjects with >24 outpatient visits and hospitalizations per year had a higher incident respiratory failure risk (aHR = 21.7, 95% CI = 18.0-26.1) compared with the non-SLE cohort.
Patients with SLE are associated with an increased risk of incident respiratory failure, regardless of their age, sex, and pre-existing comorbidities; especially medical services with higher frequency.
我们开展了一项全国性队列研究，以调查系统性红斑狼疮（SLE）与发生呼吸衰竭风险之间的关系。
从国民健康保险研究数据库中，我们识别出11533例新诊断为SLE的患者以及46132例无SLE的对照者，后者通过按年龄、性别和索引年份进行频数匹配随机选取。两个队列均随访至2011年末，以测量发生呼吸衰竭的发生率，并通过Cox比例风险回归分析在两个队列之间进行比较。
在对性别、年龄和合并症进行校正后，SLE队列发生呼吸衰竭的校正风险比（aHR）为5.80（95%置信区间[CI]=5.15-6.52）。SLE队列中的男性（aHR=3.44，95%CI=2.67-4.43）和女性（aHR=6.79，95%CI=5.93-7.77）发生呼吸衰竭的比率均显著高于非SLE队列。年龄<35岁（aHR=31.2，95%CI=21.6-45.2）、35-65岁（aHR=6.19，95%CI=5.09-7.54）和≥65岁（aHR=2.35，95%CI=1.92-2.87）的男性和女性在SLE队列中发生呼吸衰竭的风险均更高。此外，对于有（aHR=2.65，95%CI=2.22-3.15）或无（aHR=9.08，95%CI=7.72-10.7）既往合并症的受试者，SLE队列发生呼吸衰竭的风险高于非SLE队列。在SLE队列中，每年门诊就诊和住院次数>24次的受试者与非SLE队列相比，发生呼吸衰竭的风险更高（aHR=21.7，95%CI=18.0-26.1）。
SLE患者发生呼吸衰竭的风险增加，无论其年龄、性别和既往合并症如何；尤其是就诊频率较高的患者。
