Department of Genetics and Genomic Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio, USA.
Am J Med Genet A. 2023 Jul;191(7):1870-1877. doi: 10.1002/ajmg.a.63217. Epub 2023 May 3.
We aimed to investigate the prevalence, resource utilization, and comorbidities of patients with Turner syndrome (TS) hospitalized in the United States. We identified patients within the Nationwide Inpatient Sample database from the year 2017 to 2019. A propensity-matched cohort of non-TS patients from the same database was constructed to serve as comparators. There were 9845 TS patients, corresponding to inpatient prevalence of 10.4 per 100,000 admissions. The most common admission diagnosis was sepsis (27.9%). TS patients had higher inpatient mortality (adjusted odds ratio 2.16, 95% confidence interval 1.57-2.96) and morbidity, including shock, ICU admission, acute kidney injury, systemic inflammatory response syndrome, acute respiratory distress syndrome, and multi-organ failure. Increased risk of comorbidities, such as stroke, myocardial infarction, autoimmune diseases, and non-variceal gastrointestinal bleeding, was observed. TS patients had longer length of stay (LOS; 5.1 days vs. 4.5 days, p < 0.01) and displayed a mean additional $5382 (p < 0.01) in total hospital costs and a mean additional $20,083 (p < 0.01) in total hospitalization charges. In conclusion, hospitalization of patients with TS was associated with a significantly higher inpatient morbidity, mortality, expenditures, and longer LOS compared to non-TS patients. Patients with TS had a higher risk of cardiovascular complications, autoimmune diseases, and gastrointestinal bleeding.
我们旨在调查美国特纳综合征(TS)住院患者的患病率、资源利用情况和合并症。我们从 2017 年至 2019 年的全国住院患者样本数据库中确定了患者。从同一数据库中构建了一组非 TS 患者的倾向评分匹配队列作为对照。共有 9845 例 TS 患者,住院患病率为每 10 万人 10.4 例。最常见的入院诊断是败血症(27.9%)。TS 患者的住院死亡率更高(调整后的优势比 2.16,95%置信区间 1.57-2.96),发病率更高,包括休克、重症监护病房入院、急性肾损伤、全身炎症反应综合征、急性呼吸窘迫综合征和多器官衰竭。观察到合并症风险增加,如中风、心肌梗死、自身免疫性疾病和非静脉曲张性胃肠道出血。TS 患者的住院时间(LOS;5.1 天 vs. 4.5 天,p<0.01)和总住院费用(平均增加 5382 美元,p<0.01)以及总住院费用(平均增加 20083 美元,p<0.01)均更长。总之,与非 TS 患者相比,TS 患者的住院治疗与更高的住院发病率、死亡率、支出和更长的 LOS 相关。TS 患者患心血管并发症、自身免疫性疾病和胃肠道出血的风险更高。