TY - JOUR
T1 - Hospitalization rates are highest in the first 5 years of systemic sclerosis
T2 - Results from a population-based cohort (1980-2016)
AU - Coffey, Caitrin M.
AU - Sandhu, Avneek S.
AU - Crowson, Cynthia S.
AU - Achenbach, Sara J.
AU - Matteson, Eric L.
AU - Osborn, Thomas G.
AU - Warrington, Kenneth J.
AU - Makol, Ashima
N1 - Funding Information:
This study used the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health (NIH) under Award Number R01AG034676. This study was also supported by the John M. Nasseff, Sr. Clinician Career Development Award in Rheumatology to AM and Mayo Clinic CTSA through grant number UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS), one of the institutes of the NIH. 1C.M. Coffey, MD, Instructor of Medicine, T.G. Osborn, MD, Professor of Medicine, K.J. Warrington, MD, Professor of Medicine, A. Makol, MD, Assistant Professor of Medicine, Divison of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; 2A.S. Sandhu, MD, Resident Physician, Department of Internal Medicine, Kettering Medical Center, Kettering, Ohio; 3C.S. Crowson, PhD, Professor of Biostatistics and Medicine, E.L. Matteson, MD, Professor of Medicine, Divison of Rheumatology, and Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; 4S.J. Achenbach, MS, Stat Program Analyst II, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. A. Makol, Consultant, Associate Professor of Medicine, Division of Rheumatology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA. Email: Makol.ashima@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 5, 2020.
Publisher Copyright:
Copyright © 2021. All rights reserved.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Objective. Few studies have estimated the healthcare resource usage of patients with systemic sclerosis (SSc). The purpose of this study was to compare hospitalization among incident cases of SSc vs age- and sex-matched comparators. Methods. A retrospective, population-based cohort of patients with SSc in Olmsted County, Minnesota, from January 1, 1980, to December 31, 2016, was assembled. A 2:1 cohort of age- and sex-matched patients without SSc from the same population was randomly selected for comparison. All hospitalizations in the geographic area from January 1, 1987, to September 30, 2018, were obtained. Rates of hospitalization, lengths of stay, and readmissions were compared between groups. Results. There were 76 incident SSc cases and 155 non-SSc comparators (mean age 56 ± 16 yrs at diagnosis/index, 91% female) included. Rates of hospitalization among cases and comparators were 31.9 and 17.9 per 100 person-years, respectively (rate ratio [RR] 1.78, 95% CI 1.52.2.08). Hospitalization rates were higher in patients with SSc than comparators during the first 5 years after SSc diagnosis (RR 2.16, 95% CI 1.70.2.74). This difference decreased over time and was no longer significant at ≥ 15 years after SSc incidence/index. Lengths of stay (median [IQR] 4 [2.6] vs 3 [2.6], P = 0.52) and readmission rates (25% vs 23%, P = 0.51) were similar between groups. Conclusion. Patients with SSc were hospitalized more frequently than comparators, indicating high inpatient care needs in this population. Hospitalization rates were highest during the first 5 years following SSc diagnosis.
AB - Objective. Few studies have estimated the healthcare resource usage of patients with systemic sclerosis (SSc). The purpose of this study was to compare hospitalization among incident cases of SSc vs age- and sex-matched comparators. Methods. A retrospective, population-based cohort of patients with SSc in Olmsted County, Minnesota, from January 1, 1980, to December 31, 2016, was assembled. A 2:1 cohort of age- and sex-matched patients without SSc from the same population was randomly selected for comparison. All hospitalizations in the geographic area from January 1, 1987, to September 30, 2018, were obtained. Rates of hospitalization, lengths of stay, and readmissions were compared between groups. Results. There were 76 incident SSc cases and 155 non-SSc comparators (mean age 56 ± 16 yrs at diagnosis/index, 91% female) included. Rates of hospitalization among cases and comparators were 31.9 and 17.9 per 100 person-years, respectively (rate ratio [RR] 1.78, 95% CI 1.52.2.08). Hospitalization rates were higher in patients with SSc than comparators during the first 5 years after SSc diagnosis (RR 2.16, 95% CI 1.70.2.74). This difference decreased over time and was no longer significant at ≥ 15 years after SSc incidence/index. Lengths of stay (median [IQR] 4 [2.6] vs 3 [2.6], P = 0.52) and readmission rates (25% vs 23%, P = 0.51) were similar between groups. Conclusion. Patients with SSc were hospitalized more frequently than comparators, indicating high inpatient care needs in this population. Hospitalization rates were highest during the first 5 years following SSc diagnosis.
KW - Facilities and services utilization
KW - Hospitalization
KW - Systemic sclerosis
UR - http://www.scopus.com/inward/record.url?scp=85107456516&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107456516&partnerID=8YFLogxK
U2 - 10.3899/jrheum.200737
DO - 10.3899/jrheum.200737
M3 - Review article
C2 - 33191288
AN - SCOPUS:85107456516
SN - 0315-162X
VL - 48
SP - 877
EP - 882
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 6
ER -