红斑狼疮患者在学术医疗中心的住院治疗情况。
Hospitalizations in Patients with Systemic Lupus Erythematosus in an Academic Health Science Center.
机构信息
From the University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
K. Gu, BSc, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto; J. Su, MB, BSc, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto; M.B. Urowitz, MD, FRCPC, Professor of Medicine, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto.
出版信息
J Rheumatol. 2017 Aug;44(8):1173-1178. doi: 10.3899/jrheum.170072. Epub 2017 Jun 15.
OBJECTIVE
Hospitalization occurs in about 10% of patients with systemic lupus erythematosus (SLE) each year and accounts for most of the direct cost of SLE patient care. We aimed to determine the frequency of admissions of patients with SLE and describe their causes and outcomes.
METHODS
We identified all hospitalizations at University Health Network in the periods 2011-2012 and 2013-2015 with an International Classification of Diseases, 10th ed. code of M32 (SLE). A retrospective chart review of these patients categorized them based on SLE care provider and cause of admission. Frequency of emergency room visits and duration of hospitalization were ascertained. Poisson and linear regressions were performed to determine factors associated with frequency and duration of hospitalizations.
RESULTS
There were 247 unique patients with SLE who were hospitalized a total of 491 times: 87.4% were women, average age of 43.9 ± 17.9 years, and disease duration 13.7 ± 12.3 years. Incidental causes were most common (35.6%); 21.4% and 22.4% of admissions were because of active SLE and infection, respectively. The patients with SLE averaged 1.6 hospitalizations lasting 8.5 days. Thirteen percent of hospitalizations resulted in intensive care unit admission, and 2.8% of hospitalizations resulted in death. Patient employment was associated with fewer hospitalizations during 2011-2015. Antimalarial use was associated with fewer hospitalizations as well as shorter length of stay during 2011-2012. The presence of damage correlated with increased hospitalizations. Higher educational level and antimalarial use correlated with shorter length of stay.
CONCLUSION
Patients with SLE are frequently hospitalized, often because of active SLE or infection, and re-hospitalized within a short period of time.
目的
红斑狼疮（SLE）患者每年约有 10%住院，住院治疗是 SLE 患者医疗费用的主要部分。本研究旨在确定 SLE 患者的住院频率，并描述其住院原因和结局。
方法
我们在 2011-2012 年和 2013-2015 年期间，通过国际疾病分类第 10 版 M32（SLE）代码，确定了在多伦多大学健康网络（University Health Network）所有住院患者。对这些患者进行回顾性病历审查，根据 SLE 护理提供者和入院原因对其进行分类。确定了急诊就诊次数和住院时间的频率。采用泊松和线性回归来确定与住院频率和住院时间相关的因素。
结果
共有 247 例 SLE 患者，共住院 491 次：87.4%为女性，平均年龄为 43.9 ± 17.9 岁，疾病持续时间为 13.7 ± 12.3 年。最常见的是偶然原因（35.6%）；21.4%和 22.4%的住院是由于活动期 SLE 和感染。SLE 患者平均住院 1.6 次，住院时间 8.5 天。13%的住院患者需要入住重症监护病房，2.8%的住院患者死亡。2011-2015 年，患者就业与住院次数减少相关。抗疟药物的使用与 2011-2012 年住院次数减少以及住院时间缩短相关。存在组织损伤与住院次数增加相关。较高的教育程度和抗疟药物的使用与较短的住院时间相关。
结论
SLE 患者经常住院，通常是因为活动期 SLE 或感染，且在短时间内再次住院。
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