Outcomes in Hospitalized Pediatric Patients With Systemic Lupus Erythematosus

Outcomes in Hospitalized Pediatric Patients With Systemic Lupus Erythematosus
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DOI：
10.1542/peds.2013-1640
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发表时间：
2014-01-01
期刊：
PEDIATRICS
影响因子：
8
通讯作者：
Costenbader, Karen H.
Costenbader, Karen H.
中科院分区：
医学2区
文献类型：
--
作者：
Son, Mary Beth F.;Johnson, Victor M.;Costenbader, Karen H.

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目的：已有文献记载成人系统性红斑狼疮(SLE)的预后存在差异。我们调查了儿童起病的系统性红斑狼疮患者中，社会人口学因素和年住院量与住院特征和不良预后的关系。方法：利用儿科健康信息系统，我们分析了2006年1月至2011年9月，年龄在3岁到18岁之间的患者的入院情况，这些患者的入院年龄为&gt；=1国际疾病分类第九版。摘要统计和单变量分析被用来检验住院、再住院和住院时间的人口统计学特征。我们使用多变量Logistic回归分析，控制了患者性别、年龄、种族、民族、保险类型、医院数量、美国人口普查地区和疾病严重程度，以检查不良结局的危险因素。结果：在研究期间，2775名患者中共有10724人入院。西班牙裔患者住院时间更长，再入院次数更多，住院死亡率更高。在多变量分析中，非裔美国人种族与ICU入院显著相关。非洲裔美国人和西班牙裔美国人与终末期肾病和死亡有关。每个医院的SLE患者数量和医院位置与结果没有明显的相关性。结论：在这群住院的SLE儿童中，种族和民族与结果相关。需要进一步的研究来阐明社会人口学因素与儿童期起病的SLE患者不良结局之间的关系。
OBJECTIVE: Disparities in outcomes among adults with systemic lupus erythematosus (SLE) have been documented. We investigated associations between sociodemographic factors and volume of annual inpatient hospital admissions with hospitalization characteristics and poor outcomes among patients with childhood-onset SLE.METHODS: By using the Pediatric Health Information System, we analyzed admissions for patients aged 3 to,18 years at index admission with >= 1 International Classification of Diseases, Ninth Revision code for SLE from January 2006 to September 2011. Summary statistics and univariable analyses were used to examine demographic characteristics of hospital admissions, readmissions, and lengths of stay. We used multivariable logistic regression analyses, controlling for patient gender, age, race, ethnicity, insurance type, hospital volume, US census region, and severity of illness, to examine risk factors for poor outcomes.RESULTS: A total of 10 724 admissions occurred among 2775 patients over the study period. Hispanic patients had longer lengths of stay, more readmissions, and higher in-hospital mortality. In multivariable analysis, African American race was significantly associated with ICU admission. African American race and Hispanic ethnicity were associated with end-stage renal disease and death. Volume of patients with SLE per hospital and hospital location were not significantly associated with outcomes.CONCLUSIONS: In this cohort of hospitalized children with SLE, race and ethnicity were associated with outcomes. Further studies are needed to elucidate the relationship between sociodemographic factors and poor outcomes in patients with childhood-onset SLE.