Department of Medicine, Division of Rheumatology, Hospital for Special Surgery.
Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine.
Rheumatology (Oxford). 2022 Apr 11;61(4):1510-1517. doi: 10.1093/rheumatology/keab569.
To identify individual-level factors associated with hospital readmission among individuals with SSc-associated pulmonary hypertension (SSc-PH).
Individuals enrolled in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) registry contributed clinical data related to SSc-PH disease severity and hospital admissions. Readmission was defined as a subsequent hospitalization within 12 months of any hospital discharge. Characteristics were compared between individuals with and without readmissions using Fisher's exact test, Wilcoxon rank-sum test, or Kruskal-Wallis test. Logistic regression was used to estimate associations between clinical predictors and likelihood of readmission.
Of 572 individuals with SSc-PH enrolled in PHAROS, 54% had ≥1 hospitalizations between 2005 and 2016. Among individuals ever-hospitalized, 34% had ≥1 readmission. Individuals with vs without readmissions had shorter median (IQR) time between index hospitalization date and next PHAROS visit [37 (3, 80) vs 81 (42, 136) days, P <0.001]. Index admissions related to PH or SSc (vs non-PH/SSc related) were associated with an increased odds of 12-month readmission [aOR 6.6 (95% CI 3.2, 13.6) and aOR 2.2 (95% CI 1.1, 4.5), respectively]. Readmission was less likely among home oxygen users (vs non-users) (aOR 0.44; 95% CI 0.22, 0.89). Race, age, sex, disease duration and disease subtype were not associated with readmission.
The strongest predictor for 12-month readmission was an index hospitalization reason related to PH. Home oxygen use was associated with lower odds of readmission. Future studies should determine whether testing for the need for home oxygen mediates the risk of readmission in SSc-PH.
确定与系统性硬皮病相关的肺动脉高压（SSc-PH）患者住院再入院相关的个体因素。
参与肺动脉高压评估和硬皮病结局识别（PHAROS）登记的个体提供了与 SSc-PH 疾病严重程度和住院相关的临床数据。再入院定义为任何出院后 12 个月内的再次住院。使用 Fisher 确切检验、Wilcoxon 秩和检验或 Kruskal-Wallis 检验比较有和无再入院患者的特征。使用逻辑回归估计临床预测因素与再入院可能性之间的关联。
在 PHAROS 中登记的 572 名 SSc-PH 患者中，54%在 2005 年至 2016 年间有≥1 次住院。在曾经住院的患者中，34%有≥1 次再入院。与无再入院的患者相比，有再入院的患者索引住院日期和下一次 PHAROS 就诊之间的中位（IQR）时间更短[37（3，80）与 81（42，136）天，P<0.001]。与 PH 或 SSc 相关的入院（与非 PH/SSc 相关入院相比）与 12 个月再入院的几率增加相关[优势比（aOR）6.6（95%可信区间 3.2，13.6）和 aOR 2.2（95%可信区间 1.1，4.5）]。与非使用者相比，家庭氧疗使用者（aOR 0.44；95%可信区间 0.22，0.89）再入院的可能性较小。种族、年龄、性别、疾病持续时间和疾病亚型与再入院无关。
12 个月再入院的最强预测因素是与 PH 相关的索引住院原因。家庭氧疗的使用与再入院的几率降低相关。未来的研究应确定在家氧疗需求检测是否会影响 SSc-PH 患者的再入院风险。
