Hospitalizations in patients with systemic lupus erythematosus: updated analyses from 2006 to 2011
Notice bibliographique
Résumé
Health resource use is believed to be significant in patients with systemic lupus erythematosus (SLE), but there is a lack of data especially in Canadian patients regarding the reasons why persons with SLE require hospitalization and the rates of hospitalization compared with the general population. Our objective was to provide recent estimates for hospitalization rates and reasons for admission, in a clinical SLE cohort. We evaluated data from patients with SLE followed at the McGill University Health Center Lupus Clinic. Information on disease activity, drug exposure, health outcomes, and hospitalizations by self-report were collected from annual research visits. The hospitalization rates of the SLE patients were generated. We compared this with the Canadian general population by calculating the standardized incidence ratio (SIR), which represents the ratio of the number of events observed in the SLE cohort to the number of events that would be expected based on the age-specific and sex-specific Canadian general population hospitalization rates. Over the interval studied, 350 patients (325 female, 25 male) provided 1,261 person-years of follow-up. There were 163 reported admissions with an incidence of 12.8 hospitalizations per 100 person-years (12.4 in females, 19.5 in males). SLE-related causes (for example, flares) accounted for the highest proportion of hospitalization (22.7%), followed by infections (20.2%), surgery (14.7%), childbirth (11.7%) and cardiovascular reasons (11.0%). The overall SIR was 1.73 (95% CI = 1.48 to 2.02). Stratified by sex, the SIR was 2.87 (95% CI = 1.67 to 4.60) for males and 1.39 (95% CI = 1.18 to 1.64) for females. However, stratifying further by age, female SLE patients aged >65 actually underwent fewer hospitalizations than expected, based on age/sex-specific general population rates (SIR = 0.35; 95% CI = 0.17 to 0.64). In male SLE patients over 65, there were no hospitalizations (compared with 1.48 expected events), and the confidence interval (95% CI = 0.0 to 2.49) around the SIR was very imprecise in this demographic, due to the relatively low number of older males in our cohort. We documented high rates of hospitalization in our SLE patients, particularly for male patients. Hospitalizations were often due to SLE-related reasons and infections. Female SLE patients over the age of 65 were shown to have a much lower hospitalization rate compared with the general population, which may be due to a survivorship bias. Further work on the variables affecting hospitalizations in SLE patients is in progress.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».