Department of Medicine, William Beaumont Hospital, Royal Oak, USA.
Division of Rheumatology, Department of Medicine, University of Michigan Medical School, Ann Arbor, USA.
Clin Exp Rheumatol. 2021 Jul-Aug;39 Suppl 131(4):43-51. doi: 10.55563/clinexprheumatol/9ivp9g. Epub 2021 Mar 10.
To determine the primary reason for hospitalisations in systemic sclerosis (SSc) and impact of underlying interstitial lung disease (ILD) in a tertiary scleroderma centre.
A retrospective analysis on a subset of a scleroderma cohort from 2011-2019 was performed to assess causes for hospitalisations and mortality. A chart review was performed to extract demographics, primary reason for hospitalisation and inpatient mortality. Admissions were classified as SSc (if hospitalisation reason was related to primary organ dysfunction) and non-SSc related causes.
The mean age of the cohort was 53.1 years, 78% were women, and the mean disease duration was 5.2 years. Among 484 patients, 182 (37.6%) were admitted for a total of 634 admissions. In 382 SSc-related admissions, pulmonary hypertension (12.0%) and gastrointestinal dysmotility (11.0%), were major causes of urgent admissions; management of digital vasculopathy (26.1%) was the major reason for elective admissions. In 252 non-SSc related admissions, infection (respiratory:11.5%, skin and soft tissue: 6.3%) was the major reason for urgent admissions, and elective surgery (21.4%) was the major reason for elective admissions. We found 65% of all patients had underlying ILD and a greater proportion of patients with ILD were hospitalised (122 patients). Overall inpatient mortality was 9.3% and the leading cause for mortality was progressive pulmonary hypertension.
Among a large cohort of SSc patients who are followed at a tertiary scleroderma centre, 37.6 % had hospital admissions, while worsening pulmonary hypertension, ILD, cardiac involvement and infectious complications were the major cause of mortality and morbidity.
确定系统性硬化症（SSc）住院的主要原因，并评估潜在间质性肺病（ILD）对三级硬皮病中心患者的影响。
对 2011 年至 2019 年期间硬皮病队列的一个亚组进行回顾性分析，以评估住院和死亡的原因。通过病历回顾提取人口统计学、住院主要原因和住院死亡率。将住院分为 SSc（如果住院原因与主要器官功能障碍有关）和非 SSc 相关原因。
该队列的平均年龄为 53.1 岁，78%为女性，平均病程为 5.2 年。在 484 名患者中，182 名（37.6%）因总共 634 次住院而入院。在 382 例与 SSc 相关的住院中，肺动脉高压（12.0%）和胃肠动力障碍（11.0%）是紧急入院的主要原因；数字血管病变的治疗（26.1%）是择期入院的主要原因。在 252 例非 SSc 相关的住院中，感染（呼吸道：11.5%，皮肤和软组织：6.3%）是紧急入院的主要原因，择期手术（21.4%）是择期入院的主要原因。我们发现所有患者中有 65%患有潜在的ILD，且患有ILD 的患者比例更高（122 名）。总的住院死亡率为 9.3%，导致死亡的主要原因是进行性肺动脉高压。
在一家三级硬皮病中心接受治疗的大量 SSc 患者中，有 37.6%的患者住院，而肺动脉高压恶化、ILD、心脏受累和感染并发症是导致发病率和死亡率的主要原因。
