Annangi Srinadh, Dammalapati Tirumala Rao, Nutalapati Snigdha, Henriques King Marshaleen N
From the *Department of Internal Medicine, Morehouse School of Medicine; †Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Emory University School of Medicine; and ‡Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA.
J Clin Rheumatol. 2017 Jun;23(4):200-206. doi: 10.1097/RHU.0000000000000521.
Pulmonary embolism (PE) is a life threatening preventable medical condition involving sudden occlusion of arteries within the lungs. Systemic lupus erythematosus (SLE) is an inflammatory disorder and therefore independently poses a risk of PE. We aimed to determine the association of SLE and PE using National Hospital Discharge Survey data, a national representative sample of hospital discharges throughout the United States.
Retrospective population-based analysis was done using National Hospital Discharge Survey data for the period 2001 to 2010. International Classification of Diseases, Ninth Revision (ICD-9) coding was used to identify SLE (ICD-9 code 710.0) and PE (ICD-9 codes 415.11, 415.12, 415.13, and 415.19) mentioned in any of the discharge diagnosis. Patients 15 years or older were included in the study. Regression analysis was done including hyperlipidemia, heart failure, lower-limb injury or surgery, hypertension, diabetes cerebrovascular disease, and cancer.
Our regression analysis demonstrated a significant association between SLE and PE, which was independent of sex, race, age, and associated comorbidities (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.99-2.16). Of included comorbidities, primary hypercoagulable disorder has the highest odds of association with PE (OR, 15.37; 95% CI, 15.22-15.51) followed by African American race compared with whites (OR, 1.08, 95% 1.08-1.09), and presence of at least 1 of the comorbidities (OR, 1.06; 95% CI, 1.06-1.06). African American SLE cases have the higher prevalence of PE in all age groups, with the exception of persons 35 to 44 years old.
Significant association exists between SLE and PE regardless of sex, race, age, and associated comorbidities. Females had an overall higher prevalence of SLE-related PE (1.67%) compared with males (1.29%). Stratified according to sex, race, and age groups, the association is highest for females, blacks, and age group 35 to 44 years, respectively.
肺栓塞（PE）是一种危及生命的可预防疾病，涉及肺部动脉的突然阻塞。系统性红斑狼疮（SLE）是一种炎症性疾病，因此独立存在发生PE的风险。我们旨在利用国家医院出院调查数据（美国全国医院出院情况的代表性样本）来确定SLE与PE之间的关联。
使用2001年至2010年期间的国家医院出院调查数据进行基于人群的回顾性分析。采用国际疾病分类第九版（ICD - 9）编码来识别出院诊断中提及的SLE（ICD - 9编码710.0）和PE（ICD - 9编码415.11、415.12、415.13和415.19）。研究纳入15岁及以上的患者。进行回归分析，纳入高脂血症、心力衰竭、下肢损伤或手术、高血压、糖尿病、脑血管疾病和癌症。
我们的回归分析表明SLE与PE之间存在显著关联，且该关联独立于性别、种族、年龄和相关合并症（比值比[OR]为2.0；95%置信区间[CI]为1.99 - 2.16）。在纳入的合并症中，原发性高凝性疾病与PE的关联几率最高（OR为15.37；95% CI为15.22 - 15.51），其次是与白人相比的非裔美国人种族（OR为1.08，95%为1.08 - 1.09），以及存在至少一种合并症（OR为1.06；95% CI为1.06 - 1.06）。除35至44岁人群外，非裔美国人SLE病例在所有年龄组中PE患病率更高。
无论性别、种族、年龄和相关合并症如何，SLE与PE之间均存在显著关联。女性SLE相关PE的总体患病率（1.67%）高于男性（1.29%）。按性别、种族和年龄组分层后，该关联分别在女性、黑人以及35至44岁年龄组中最为明显。
