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Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States

Background: This study aimed to evaluate thrombotic microangiopathy’s (TMA) incidence, risk factors, and impact on outcomes and resource use in hospitalized patients with systemic lupus erythematosus (SLE). Methods: We used the National Inpatient Sample to construct a cohort of hospitalized patients...

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Autores principales: Pivovarova, Aleksandra I., Thongprayoon, Charat, Hansrivijit, Panupong, Kaewput, Wisit, Qureshi, Fawad, Boonpheng, Boonphiphop, Bathini, Tarun, Mao, Michael A, Vallabhajosyula, Saraschandra, Cheungpasitporn, Wisit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838946/
https://www.ncbi.nlm.nih.gov/pubmed/33374384
http://dx.doi.org/10.3390/diseases9010003
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author Pivovarova, Aleksandra I.
Thongprayoon, Charat
Hansrivijit, Panupong
Kaewput, Wisit
Qureshi, Fawad
Boonpheng, Boonphiphop
Bathini, Tarun
Mao, Michael A
Vallabhajosyula, Saraschandra
Cheungpasitporn, Wisit
author_facet Pivovarova, Aleksandra I.
Thongprayoon, Charat
Hansrivijit, Panupong
Kaewput, Wisit
Qureshi, Fawad
Boonpheng, Boonphiphop
Bathini, Tarun
Mao, Michael A
Vallabhajosyula, Saraschandra
Cheungpasitporn, Wisit
author_sort Pivovarova, Aleksandra I.
collection PubMed
description Background: This study aimed to evaluate thrombotic microangiopathy’s (TMA) incidence, risk factors, and impact on outcomes and resource use in hospitalized patients with systemic lupus erythematosus (SLE). Methods: We used the National Inpatient Sample to construct a cohort of hospitalized patients with SLE from 2003–2014. We compared clinical characteristics, in-hospital treatments, outcomes, and resource use between SLE patients with and without TMA. Results: Of 35,745 hospital admissions for SLE, TMA concurrently presented or developed in 188 (0.5%) admissions. Multivariable analysis showed that age ≥ 40 years and Hispanics were significantly associated with decreased risk of TMA, whereas Asian/Pacific Islanders and history of chronic kidney disease were significantly associated with increased risk of TMA. TMA patients required more kidney biopsy, plasmapheresis, mechanical ventilation, and renal replacement therapy. TMA was significantly associated with increased risk of in-hospital mortality and acute conditions including hemoptysis, glomerulonephritis, encephalitis/myelitis/encephalopathy, hemolytic anemia, pneumonia, urinary tract infection, sepsis, ischemic stroke, seizure, and acute kidney injury. The length of hospital stays and hospitalization cost was also significantly higher in SLE with TMA patients. Conclusion: TMA infrequently occurred in less than 1% of patients admitted for SLE, but it was significantly associated with higher morbidity, mortality, and resource use.
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spelling pubmed-78389462021-01-28 Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States Pivovarova, Aleksandra I. Thongprayoon, Charat Hansrivijit, Panupong Kaewput, Wisit Qureshi, Fawad Boonpheng, Boonphiphop Bathini, Tarun Mao, Michael A Vallabhajosyula, Saraschandra Cheungpasitporn, Wisit Diseases Article Background: This study aimed to evaluate thrombotic microangiopathy’s (TMA) incidence, risk factors, and impact on outcomes and resource use in hospitalized patients with systemic lupus erythematosus (SLE). Methods: We used the National Inpatient Sample to construct a cohort of hospitalized patients with SLE from 2003–2014. We compared clinical characteristics, in-hospital treatments, outcomes, and resource use between SLE patients with and without TMA. Results: Of 35,745 hospital admissions for SLE, TMA concurrently presented or developed in 188 (0.5%) admissions. Multivariable analysis showed that age ≥ 40 years and Hispanics were significantly associated with decreased risk of TMA, whereas Asian/Pacific Islanders and history of chronic kidney disease were significantly associated with increased risk of TMA. TMA patients required more kidney biopsy, plasmapheresis, mechanical ventilation, and renal replacement therapy. TMA was significantly associated with increased risk of in-hospital mortality and acute conditions including hemoptysis, glomerulonephritis, encephalitis/myelitis/encephalopathy, hemolytic anemia, pneumonia, urinary tract infection, sepsis, ischemic stroke, seizure, and acute kidney injury. The length of hospital stays and hospitalization cost was also significantly higher in SLE with TMA patients. Conclusion: TMA infrequently occurred in less than 1% of patients admitted for SLE, but it was significantly associated with higher morbidity, mortality, and resource use. MDPI 2020-12-24 /pmc/articles/PMC7838946/ /pubmed/33374384 http://dx.doi.org/10.3390/diseases9010003 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pivovarova, Aleksandra I.
Thongprayoon, Charat
Hansrivijit, Panupong
Kaewput, Wisit
Qureshi, Fawad
Boonpheng, Boonphiphop
Bathini, Tarun
Mao, Michael A
Vallabhajosyula, Saraschandra
Cheungpasitporn, Wisit
Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States
title Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States
title_full Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States
title_fullStr Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States
title_full_unstemmed Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States
title_short Thrombotic Microangiopathy among Hospitalized Patients with Systemic Lupus Erythematosus in the United States
title_sort thrombotic microangiopathy among hospitalized patients with systemic lupus erythematosus in the united states
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838946/
https://www.ncbi.nlm.nih.gov/pubmed/33374384
http://dx.doi.org/10.3390/diseases9010003
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