Intestinal pseudo-obstruction in patients with systemic sclerosis: an analysis of the Nationwide Inpatient Sample
Intestinal pseudo-obstruction in patients with systemic sclerosis: an analysis of the Nationwide Inpatient Sample
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DOI：
10.1093/rheumatology/kev393
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发表时间：
2016-04-01
期刊：
影响因子：
5.5
通讯作者：
Chung, Lorinda
中科院分区：
文献类型：
--
作者：
Valenzuela, Antonia;Li, Shufeng;Chung, Lorinda
Objective.假性肠梗阻是SSc患者罕见的胃肠道并发症，目前尚无大型研究对其患病率或结局进行评估。我们的目的是比较SSc患者假性肠梗阻患者继发于其他原因的假性肠梗阻患者和SSc患者无假性肠梗阻的结局。这是一项病例对照研究，使用2002-2011年期间的医疗保健成本和利用项目全国住院患者样本。我们纳入了先前验证过的SSc国际疾病分类-临床修改-9代码710.1与假性肠梗阻代码的患者，并确定了住院时间和外科手术的风险，全肠外营养（TPN）的使用和住院死亡率。2002年至2011年期间，美国共发生193610例SSc住院，其中5.4%（n = 10386）与并发假性肠梗阻诊断（病例）相关。住院死亡率为7.3%。在多变量分析中，与特发性假性肠梗阻患者（对照组1）、假性肠梗阻合并糖尿病患者（对照组2）和无假性肠梗阻的SSc患者（对照组3）相比，病例在住院期间和接受TPN的可能性更高。病例的住院时间较对照组2和3长，手术率较对照组1和2低。假性肠梗阻是SSc患者住院的罕见原因，但与其他SSc患者和继发于其他原因的假性肠梗阻患者相比，其住院死亡率较高。
Objective. Intestinal pseudo-obstruction is a rare gastrointestinal complication in patients with SSc without large studies examining its prevalence or outcomes. We aimed to compare outcomes in SSc patients with intestinal pseudo-obstruction to patients with intestinal pseudo-obstruction secondary to other causes, and SSc patients without intestinal pseudo-obstruction.Methods. This is a case-control study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample for the period 2002-2011. We included patients with the previously validated International Classification of Diseases-Clinical Modification-9 code 710.1 for SSc in combination with codes for intestinal pseudo-obstruction, and determined length of hospitalization and the risks for surgical procedures, use of total parenteral nutrition (TPN) and in-hospital mortality.Results. A total of 193 610 SSc hospitalizations occurred in the USA between 2002 and 2011, of which 5.4% (n = 10 386) were associated with a concurrent intestinal pseudo-obstruction diagnosis (cases). Inhospital mortality was 7.3%. In multivariate analyses, cases were more likely to die during the inpatient stay and to receive TPN than patients with idiopathic intestinal pseudo-obstruction (control group 1), patients with intestinal pseudo-obstruction and diabetes (control group 2), and SSc patients without intestinal pseudo-obstruction (control group 3). Cases had longer in-hospital stay than control groups 2 and 3, and were less likely to undergo surgical procedures than control groups 1 and 2.Conclusion. Intestinal pseudo-obstruction is a rare cause of hospitalization in patients with SSc, but is associated with high in-hospital mortality in comparison with other SSc patients and those with intestinal pseudo-obstruction secondary to other causes.