Rheumatology:系统性硬化相关性肺动脉高压患者重复入院的相关风险因素

2021-07-20 MedSci原创 MedSci原创

与SSc-PH患者12个月内再入院相关的最强预测因素是与PH相关的住院指标

系统性硬化(SSc)是一种以炎症、纤维化和血管病变为特征的自身免疫性疾病,肺动脉高压(PH)是SSc患者死亡的主要原因之一。WHO根据肺压力和病因将PH分成⑤组:

第1组:肺动脉高压(PAH);第2组:肺静脉高压;第3组:伴有呼吸系统疾病或低氧血症的肺动脉高压;第4组:慢性血栓性或栓塞性疾病引起的肺动脉高压;第5组:其他原因(如硬化症)引起的肺动脉高压。

本研究旨在确定与系统性硬化症相关的肺动脉高压 (SSc-PH) 患者再入院相关的个体水平因素。

招募了参加肺动脉高压评估和硬化症预后评估(PHAROS)注册的患者,采集了与SSc-PH疾病严重程度和住院率相关的临床数据。再入院定义为出院后12个月内再次住院。使用Fisher精确检验、Wilcoxon秩和检验或Kruskal Wallis 检验比较有无再入院个体的特征。

12个月内再入院的风险因素的优势比

在PHAROS登记的572位SSc-PH患者中,54%的患者于2015年至2016年期间住院1次或以上。在曾经住院过的个体中,34%的个体再入院≥1次。与无再入院的个体相比,有再入院经历的个体首次住院和下次PHAROS就诊之间的间隔中位时间较短(37 vs 81天;p<0.001)。与PH或SSc相关的指数入院与12个月内再入院的几率增加有关(aOR分别是6.6和2.2)。与非家庭氧气用户相比,家庭氧气用户再入院的可能性较小(aOR 0.44)。最后,种族、年龄、相比、病程长短和疾病亚型均与再入院风险无关。

综上所述,与SSc-PH患者12个月内再入院相关的最强预测因素是与PH相关的住院指标。家庭氧气的使用可降低再入院的几率。未来研究应明确是否需要通过家庭氧气来降低SSc-PH患者的再入院风险。

原始出处:

Showalter Kimberly,Pinheiro Laura C,Jannat-Khah Deanna et al. Hospital readmission in systemic sclerosis associated pulmonary hypertension: Results from the PHAROS registry.[J] .Rheumatology (Oxford), 2021, https://doi.org/10.1093/rheumatology/keab569

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    2021-07-20 明天jing

    肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。

    0

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