Effect of Systemic Lupus Erythematosus on the Risk of Incident Respiratory Failure: A National Cohort Study

doi:10.1371/journal.pone.0163382

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Title:	Effect of Systemic Lupus Erythematosus on the Risk of Incident Respiratory Failure: A National Cohort Study
Authors:	Yeh, Jun-Jun Wang, Yu-Chiao Chen, Jiunn-Horng Hsu, Wu-Huei
Contributors:	Chia Yi Christian Hosp, Ditmanson Med Fdn Chia Nan Univ Pharm & Sci Meiho Univ China Med Univ Hosp, Management Off Hlth Data China Med Univ, Coll Med China Med Univ, Coll Med, Grad Inst Clin Med Sci China Med Univ Hosp, Dept Internal Med, Div Rheumatol China Med Univ Hosp, Dept Internal Med, Div Pulm & Crit Care Med
Keywords:	of-death analysis antiphospholipid syndrome retrospective cohort organ involvement clinical-picture ischemic-stroke icd-9-cm codes population mortality pneumonia
Date:	2016-09
Issue Date:	2018-01-18 11:40:54 (UTC+8)
Publisher:	Public Library Science
Abstract:	Purpose We conducted a nationwide cohort study to investigate the relationship between systemic lupus erythematosus (SLE) and the risk of incident respiratory failure. Methods From the National Health Insurance Research Database, we identified 11 533 patients newly diagnosed with SLE and 46 132 controls without SLE who were randomly selected through frequency-matching according to age, sex, and index year. Both cohorts were followed until the end of 2011 to measure the incidence of incident respiratory failure, which was compared between the 2 cohorts through a Cox proportional hazards regression analysis. Results The adjusted hazard ratio (aHR) of incident respiratory failure was 5.80 (95% confidence interval [CI] = 5.15-6.52) for the SLE cohort after we adjusted for sex, age, and comorbidities. Both men (aHR = 3.44, 95% CI = 2.67-4.43) and women (aHR = 6.79, 95% CI = 5.93-7.77) had a significantly higher rate of incident respiratory failure in the SLE cohort than in the non-SLE cohort. Both men and women aged < 35 years (aHR = 31.2, 95% CI = 21.6-45.2), 35-65 years; (aHR = 6.19, 95% CI = 5.09-7.54) and >= 65 years (aHR = 2.35, 95% CI = 1.92-2.87) had a higher risk of incident respiratory failure in the SLE cohort. Moreover, the risk of incident respiratory failure was higher in the SLE cohort than the non-SLE cohort, for subjects with (aHR = 2.65, 95% CI = 2.22-3.15) or without (aHR = 9.08, 95% CI = 7.72-10.7) pre-existing comorbidities. In the SLE cohort, subjects with >24 outpatient visits and hospitalizations per year had a higher incident respiratory failure risk (aHR = 21.7, 95% CI = 18.0-26.1) compared with the non-SLE cohort. Conclusion Patients with SLE are associated with an increased risk of incident respiratory failure, regardless of their age, sex, and pre-existing comorbidities; especially medical services with higher frequency.
Relation:	Plos One, v.11 n.9, e0163382
Appears in Collections:	[Dept. of Childhood Education and Nursery] Periodical Articles

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