Assessment of hospitalization and mortality of scleroderma in-patients: a thirteen-year study

Abstract

ObjectiveSystemic sclerosis (SSc) is an uncommon non-hereditary sporadic disease that increases the risk of premature death, especially in diffuse type. We determined the prevalence of SSc in the last 13 years in our rheumatologic hospitals as a referral center for southern Iranian patients, the causes of hospitalization, the average length of stay (LOS), the mortality rate, and the reason for their mortality.Material and methodsA cross-sectional study was performed in Shiraz University of Medical Sciences, Iran. The studied population included all patients diagnosed with systemic sclerosis. We calculated the hospitalization rates, in-hospital mortality rates, and mean LOS.ResultsThere were 446 admissions by 181 patients with SSc. The female to male ratio was about 10.7 : 1. The overall mean LOS was 5.95 days. Digital ulcer and interstitial lung disease (ILD) were the most common causes of hospitalizations among the SSc-related events. For those with a non-SSc-related condition, infection was the most prevalent event. Most of the deaths were due to ILD and pulmonary artery hypertension(PAH), and the overall in-hospital mortality rate was 16.5%.ConclusionsWomen with SSc had higher rates of hospitalization but lower in-hospital mortality than men.There were some differences between our study and other similar studies in the causes of hospitalization and in-hospital death among SSc patients, especially the lower age of death. The patients with digital ulcers and those with intestinal lung disease or pulmonary hipertension were most commonly admitted to the hospital in our study group. Probably, increasing the skin care of these patients and asking other specialty groups to cooperate will decrease the high rate of hospitalizations in our population.

Acute hospitalization in a cohort of patients with systemic sclerosis: a 10-year retrospective cohort study

“…However, causes of acute admission changed over time, and are different from those reported in studies prior to 2010. In our cohort there was a higher percentage of hospitalizations due to infection (27%) and cardiac disease (16.5%), and not ILD as reported in other studies [ 13 , 14 , 16 ]. Tables 4 , 5 summarizes published studies on hospitalization of patients with systemic sclerosis.…”

“…Piga M. et al [ 14 ] performed an annual trend analysis showing a statistically significant increase in the percentage of ILD ( p < 0.0001), PAH ( p < 0.0024), digital ulcers, and gangrene ( p = 0.0037), between the years of 2001–2012. In a study by Shenavandeh S. et al [ 16 ] including 181 patients and 446 admissions, comprising a total of 13 years of follow-up (1999–2012), the most common causes of hospitalization were DU in 39.7%, and interstitial lung disease and PH in 21.1%. Additionally, ILD and PH were the most frequent causes of mortality in 33.3% of the cohort.…”

Use of red cell distribution width in a population at high risk for pulmonary hypertension

“…Approximately 8-12% of patients with SSc will develop PH [24][25] and it is one of the leading causes of death in this condition 26 . Despite extensive efforts at the early identification of PH in SSc patients, this population continues to have PH detected at an advanced stage 27 .…”

Causes and types of disease in elderly patients leading to one or multiple hospital admissions in rheumatology wards of southwestern Iran: A 6-year review

“…The difference between sexes has been proven by previous studies on most rheumatic diseases. In most rheumatic diseases like PMR, GCA, scleroderma, SLE, etc., female gender was a predisposing factor; one exception is gout, which was more prevalent in men [4][5][6][7].…”

“…In the group with known rheumatologic diseases, the second most prevalent cause of admission was scleroderma (5.9%), and the third was SLE (3.7%). The causes of the high rate of scleroderma admissions have been studied by the authors in a previously published study; although all age groups of patients were evaluated, it was found that uncontrolled digital ulcers, interstitial lung disease (ILD), and infections were the most common causes of hospitalization for this group of patients in the studied center (4).…”