三级医院系统性红斑狼疮住院病人的死亡率。

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-09-01 Epub Date: 2025-07-15 DOI:10.1177/09612033251360287
Mohan Kumar Hanumanthappa, Manisha Gulia, Vikas Sharma, Navneet Arora, Godasi Srsnk Naidu, Valliappan Muthu, Vishal Sharma, Varun Dhir, Manish Rathi, Harbir Singh Kohli, Sanjay Jain, Aman Sharma
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引用次数: 0

摘要

背景:系统性红斑狼疮(SLE)与显著的发病率和死亡率相关,特别是在住院期间。区分感染和疾病活动至关重要,但具有挑战性。感染率和疾病表现的区域差异需要对区域进行具体研究。目的评估SLE患者住院时或住院期间感染是否与死亡率增加相关,并确定不良结局的其他预测因素。方法本回顾性病例对照研究纳入2012年1月至2021年12月期间住院的SLE患者。病例(n = 111)是住院期间死亡的患者,根据年龄(±3岁)和性别,每年分层,与对照组(n = 222)的1:2匹配。SLE诊断依据ACR 1997或SLICC 2012标准。排除COVID-19病例。患者按入院原因分为“感染”、“疾病相关”或“混合”。提取了人口统计学、临床特征、实验室参数和治疗的数据,并用多变量逻辑回归确定了死亡率的独立预测因子。结果住院死亡率为8.9%。感染(有或没有疾病活动)对非幸存者(57%)和幸存者(25%;P < 0.001)。鲍曼不动杆菌是最常见的病原体。多变量分析显示,住院感染(OR 3.37, 95% CI 1.85-6.13)、肺部受累(OR 3.06, 95% CI 1.52-6.18)、心脏受累(OR 2.13, 95% CI 1.07-4.25)和血清肌酐水平是死亡率的独立预测因子。较高的血清白蛋白具有保护作用(OR 0.53, 95% CI 0.35-0.79)。青少年狼疮亚组分析(n = 38)显示相似的感染相关死亡模式。我们的研究强调了感染,特别是医院获得性感染对住院SLE患者死亡率的重要影响。需要提高临床警惕性,早期干预和严格的感染控制措施来改善住院SLE患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mortality among inpatients with systemic lupus erythematosus in a tertiary care hospital.

BackgroundSystemic lupus erythematosus (SLE) is associated with significant morbidity and mortality, particularly during hospitalisation. Differentiating between infection and disease activity is crucial but challenging. Regional variations in infection rates and disease manifestations necessitate region-specific studies.ObjectivesTo evaluate whether infections at or during hospitalisation are associated with increased mortality among SLE patients and identify additional predictors of adverse outcomes.MethodsThis retrospective case-control study included SLE patients hospitalised between January 2012 and December 2021. Cases (n = 111) were patients who expired during hospitalisation, matched 1:2 with controls (n = 222) discharged alive, based on age (±3 years) and sex, stratified annually. SLE diagnosis was based on ACR 1997 or SLICC 2012 criteria. COVID-19 cases were excluded. Patients were categorised by admission cause as 'Infection', 'Disease-associated', or 'Mixed'. Data on demographics, clinical features, laboratory parameters, and treatments were extracted, and multivariable logistic regression identified independent predictors of mortality.ResultsThe hospital mortality rate was 8.9%. Infection (with or without disease activity) significantly contributed to hospital admissions among non-survivors (57%) compared to survivors (25%; p < 0.001). Acinetobacter baumannii was the most frequent pathogen. Multivariable analysis showed infection at hospitalisation (OR 3.37, 95% CI 1.85-6.13), pulmonary involvement (OR 3.06, 95% CI 1.52-6.18), cardiac involvement (OR 2.13, 95% CI 1.07-4.25), and serum creatinine levels as independent predictors of mortality. Higher serum albumin was protective (OR 0.53, 95% CI 0.35-0.79). Juvenile lupus subgroup analysis (n = 38) revealed similar infection-related mortality patterns.ConclusionsOur study highlights the significant impact of infections, particularly hospital-acquired infections, on mortality among hospitalised SLE patients. Enhanced clinical vigilance, early interventions, and rigorous infection control measures are needed to improve outcomes in hospitalised SLE patients.

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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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