Canenguez Benitez Johanna S, Jaka Sanobar, Roshan Nikhita S, Kommuru Sravani, Ahmed Samreen, Kaur Gagan, Desai Ninad
Medicine, Shanti Gopal Hospital, Ghaziabad, IND.
Internal Medicine, Larkin Community Hospital, South Miami, USA.
Cureus. 2022 Jul 29;14(7):e27435. doi: 10.7759/cureus.27435. eCollection 2022 Jul.
Objectives To evaluate the risk factors and hospitalization outcomes for cerebrovascular diseases (CVD) in patients with vasculitis. Methods We conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS), 2019. We included 26,855 adults (aged 18 to 65 years, average age 48.57 ± 12.79 years) with a co-diagnosis of vasculitis, and the sample was divided by the primary diagnosis of CVD (N = 670, 2.5%). A demographic-adjusted logistic regression model was used to evaluate the odds ratio (OR) of association with CVD in patients with vasculitis by comparing it to the non-CVD cohort. Results The majority of the vasculitis patients with CVD were elders (51 to 65 years, 46%), females (62%), and whites (52%). There was a significant difference in the geographic distribution of CVD with vasculitis with the highest prevalence in the South Atlantic (23%) and Middle Atlantic (16%), and the lowest in the Mountain (4%) and New England (2%). Vasculitis patients with comorbid lymphoma (OR 2.46, P<0.001), peripheral vascular diseases (PVD (OR 1.54, P<0.001)), and complicated hypertension (OR 1.31, P<0.001) were associated with increasing the likelihood for CVD-related hospitalization. The mean length of stay was 13 days and the mean cost was $169,440 per CVD-related hospitalization in vasculitis patients. Cerebrovascular diseases in patients with vasculitis resulted in a major loss of body functioning (80%) leading to adverse disposition including transfer to a skilled nursing facility/intermediate care facility (22%) and requiring home health care (13%). Conclusion The prevalence of CVD-related hospitalization in vasculitis patients was 2.5% and females were observed to be at higher risk. Comorbid lymphoma, PVD, and hypertension further increase the risk for CVD with vasculitis. They have a higher loss of functioning that affects patient quality of life and require increased care after hospital discharge.
目的 评估血管炎患者发生脑血管疾病(CVD)的危险因素及住院结局。方法 我们使用2019年全国住院患者样本(NIS)进行了一项横断面研究。我们纳入了26855名同时诊断为血管炎的成年人(年龄在18至65岁之间,平均年龄48.57±12.79岁),样本根据CVD的主要诊断进行划分(N = 670,2.5%)。采用人口统计学调整的逻辑回归模型,通过与非CVD队列比较,评估血管炎患者发生CVD的关联比值比(OR)。结果 大多数患有CVD的血管炎患者为老年人(51至65岁,46%)、女性(62%)和白人(52%)。血管炎合并CVD的地理分布存在显著差异,南大西洋地区(23%)和中大西洋地区(16%)患病率最高,山区(4%)和新英格兰地区(2%)最低。合并淋巴瘤(OR 2.46,P<0.001)、外周血管疾病(PVD,OR 1.54,P<0.001)和复杂性高血压(OR 1.31,P<0.001)的血管炎患者发生CVD相关住院的可能性增加。血管炎患者CVD相关住院的平均住院时长为13天,平均费用为169440美元。血管炎患者的脑血管疾病导致身体功能严重丧失(80%),导致不良处置,包括转至专业护理机构/中级护理机构(22%)和需要家庭医疗护理(13%)。结论 血管炎患者CVD相关住院的患病率为2.5%,女性风险更高。合并淋巴瘤、PVD和高血压会进一步增加血管炎患者发生CVD的风险。它们导致更高的功能丧失,影响患者生活质量,出院后需要更多护理。