Ahmed Ahmed, Shaikh Amjad, Rajwana Yasir, Ahlawat Sushil
Gastroenterology and Hepatology, Rutgers University New Jersey Medical School, Newark, USA.
Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA.
Cureus. 2022 Jul 6;14(7):e26603. doi: 10.7759/cureus.26603. eCollection 2022 Jul.
Purpose Though there are studies on other autoimmune diseases, the literature is deficient on the associations between systemic lupus erythematosus (SLE) and diverticulitis. This study aims to evaluate the effects of SLE on clinical outcomes and in-patient mortality in patients with diverticulitis. Methods The National Inpatient Sample (NIS) database was used to identify adult patients with diverticulitis-related hospitalizations from 2012 to 2014 using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Primary outcomes were mortality, hospital charges, and length of stay (LOS). Secondary outcomes were effects on the complications associated with diverticulitis. Chi-squared tests and independent t-tests were used. Multivariate analysis was performed to assess the primary outcomes after adjusting for confounding variables. Results There were 2,553,320 diverticulitis-related hospitalizations from 2012 to 2014, of which 13,600 patients had SLE. The average LOS was 5.2 days, mortality rate was 0.8%, and total hospital charges per patient were $43,970. SLE was associated with a statistically significant longer LOS and higher hospital costs. SLE was statistically significant for having higher perforation rates but lower rates for morality, abscesses, and fistula formation. Differences in complications such as sepsis, gastrointestinal bleeding, and surgical intervention requirement were non-significant. Conclusion Since SLE causes a high inflammatory state, one would expect higher rates of complications and possibly higher mortality rates in those with concomitant diverticulitis. However, although there was a higher LOS and hospital cost, the mortality rate was lower and only a complication of perforation was found to be higher in SLE patients.
目的 尽管有关于其他自身免疫性疾病的研究，但系统性红斑狼疮（SLE）与憩室炎之间关联的文献尚不足。本研究旨在评估SLE对憩室炎患者临床结局和住院死亡率的影响。方法 使用国家住院样本（NIS）数据库，通过国际疾病分类第九版临床修订本（ICD - 9 - CM）编码，识别2012年至2014年因憩室炎住院的成年患者。主要结局指标为死亡率、住院费用和住院时长（LOS）。次要结局指标为对与憩室炎相关并发症的影响。采用卡方检验和独立t检验。进行多变量分析以在调整混杂变量后评估主要结局。结果 2012年至2014年有2,553,320例与憩室炎相关的住院病例，其中13,600例患者患有SLE。平均住院时长为5.2天，死亡率为0.8%，每位患者的总住院费用为43,970美元。SLE与具有统计学意义的更长住院时长和更高住院费用相关。SLE在穿孔率较高但死亡率、脓肿形成率和瘘管形成率较低方面具有统计学意义。败血症、胃肠道出血和手术干预需求等并发症的差异无统计学意义。结论 由于SLE会导致高度炎症状态，人们预期合并憩室炎的患者并发症发生率更高，可能死亡率也更高。然而，尽管住院时长更长且住院费用更高，但SLE患者的死亡率更低，仅发现穿孔并发症发生率更高。
