Maria G Tektonidou1, Abhijit Dasgupta2, Michael M Ward2. 1. First Department of Propaedeutic Internal Medicine, Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 2. Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
Abstract
OBJECTIVE: To determine whether the risk of mortality in patients with SLE hospitalized with sepsis varies among hospitals in the USA. METHODS: We used the National Inpatient Sample (2002-2011) to obtain national population-based data on outcomes for adults with SLE admitted with sepsis, and compared it with that for patients without SLE admitted with sepsis at the same hospital. We computed expected mortality based on patient demographic characteristics, comorbidities and major organ dysfunction, and calculated observed/expected (O/E) mortality ratios separately for patients with SLE and without SLE for each hospital. We then computed the ratio of these O/E ratios within hospitals to assess relative SLE mortality. We considered hospitals with a risk ratio (RR) of ⩾2.0 as having high relative SLE mortality. RESULTS: Among 424 hospitals that treated a total of 4024 patients with SLE and sepsis, the risk of in-hospital mortality varied from 0% to 60% (median 11.1%). The RR ranged from 0 to 9.75, with a median of 0.84, indicating that O/E mortality was similar in patients with and without SLE at the average hospital. Sixty-one hospitals (14.4%) had a RR of ⩾2.0, indicating higher mortality among patients with SLE. Hospitals that on average treated ⩾3.9 patients with SLE and sepsis annually were less likely to have a RR of ⩾2.0 than hospitals that treated fewer patients (10% vs 17%; P = 0.004). CONCLUSION: Mortality among patients with SLE and sepsis varied widely between hospitals, and was lower at hospitals that treated more of these patients. Published by Oxford University Press on behalf of the British Society for Rheumatology 2019. This work is written by US Government employees and is in the public domain in the US.
OBJECTIVE: To determine whether the risk of mortality in patients with SLE hospitalized with sepsis varies among hospitals in the USA. METHODS: We used the National Inpatient Sample (2002-2011) to obtain national population-based data on outcomes for adults with SLE admitted with sepsis, and compared it with that for patients without SLE admitted with sepsis at the same hospital. We computed expected mortality based on patient demographic characteristics, comorbidities and major organ dysfunction, and calculated observed/expected (O/E) mortality ratios separately for patients with SLE and without SLE for each hospital. We then computed the ratio of these O/E ratios within hospitals to assess relative SLE mortality. We considered hospitals with a risk ratio (RR) of ⩾2.0 as having high relative SLE mortality. RESULTS: Among 424 hospitals that treated a total of 4024 patients with SLE and sepsis, the risk of in-hospital mortality varied from 0% to 60% (median 11.1%). The RR ranged from 0 to 9.75, with a median of 0.84, indicating that O/E mortality was similar in patients with and without SLE at the average hospital. Sixty-one hospitals (14.4%) had a RR of ⩾2.0, indicating higher mortality among patients with SLE. Hospitals that on average treated ⩾3.9 patients with SLE and sepsis annually were less likely to have a RR of ⩾2.0 than hospitals that treated fewer patients (10% vs 17%; P = 0.004). CONCLUSION: Mortality among patients with SLE and sepsis varied widely between hospitals, and was lower at hospitals that treated more of these patients. Published by Oxford University Press on behalf of the British Society for Rheumatology 2019. This work is written by US Government employees and is in the public domain in the US.
Authors: Íñigo Rúa-Figueroa; Javier López-Longo; María Galindo-Izquierdo; Jaime Calvo-Alén; Víctor Del Campo; Alejandro Olivé-Marqués; Sabina Pérez-Vicente; Antonio Fernández-Nebro; Mariano Andrés; Celia Erausquin; Eva Tomero; Loreto Horcada; Esther Uriarte; Mercedes Freire; Carlos Montilla; Ana Sánchez-Atrio; Gregorio Santos; Alina Boteanu; Elvira Díez-Álvarez; Javier Narváez; Víctor Martínez-Taboada; Lucía Silva-Fernández; Esther Ruiz-Lucea; José Luis Andreu; José Ángel Hernández-Beriain; Marian Gantes; Blanca Hernández-Cruz; José Pérez-Venegas; Ángela Pecondón-Español; Carlos Marras; Mónica Ibáñez-Barceló; Gema Bonilla; Vicente Torrente; Iván Castellví; Juan José Alegre; Joan Calvet; Jose Luis Marenco; Enrique Raya; Tomás Vázquez; Victor Quevedo; Santiago Muñoz-Fernández; Manuel Rodríguez-Gómez; Jesús Ibáñez; José M Pego-Reigosa Journal: Semin Arthritis Rheum Date: 2017-01-27 Impact factor: 5.532
Authors: Linda Peelen; Nicolette F de Keizer; Niels Peek; Gert Jan Scheffer; Peter H J van der Voort; Evert de Jonge Journal: Crit Care Date: 2007 Impact factor: 9.097