Abstract
ObjectivesFew studies have evaluated the association between Sjogren's syndrome (SS) and respiratory failure (RF). Thus, we conducted a retrospective national cohort study to investigate whether Sjogren's syndrome (SS) increases the risk of respiratory failure (RF).MethodsThe cohort consisted of 4954 newly diagnosed patients with SS but without a previous diagnosis of RF, and 19816 patients as the comparison cohort from the catastrophic illnesses registry, obtained from the 2000–2005 period. All of the study participants were followed from the index date to December 31, 2011. We analyzed the association between the risk of RF and SS by using a Cox proportional hazards regression model, controlling for sex, age, and comorbidities.ResultsThe overall incidence rate of RF showed a 3.21-fold increase in the SS cohort compared with the comparison cohort. The adjusted HR of RF was 3.04 for the SS cohort compared with the comparison cohort, after we adjusted for sex, age, and comorbidities. The HRs of RF for patients with primary SS and secondary SS compared with the comparison cohort were 2.99 and 3.93, respectively (P for trend <.001). The HRs of RF increased as the severity of SS increased, from 2.34 for those with no inpatient care experience to 5.15 for those with inpatient care experience (P for trend <.001).ConclusionThis study indicates that clinical physicians should not only consider secondary SS but also primary SS as a critical factor that increases the risk of RF.
Highlights
Respiratory failure (RF) remains a common reason for admission to intensive care units (ICUs) [1]
We identified the following as comorbidities before the index date: pneumonia (ICD-9-CM code 480-487), asthma (ICD-9-CM code 493 and 494), hypertension (ICD-9-CM code 401-405), diabetes mellitus (DM, ICD-9-CM code 250), chronic obstructive pulmonary disease (COPD, ICD-9-CM code 491, 492 and 496), pulmonary embolism (PE, ICD-9-CM code 415.1, 639.6 and 673.8), thyroid disease (ICD-9-CM code 240-242 and 244-246), and lymphoma (ICD-9-CM code 200-208)
The s syndrome (SS) cohort had a higher proportion of comorbidities, such as pneumonia, asthma, hypertension, DM, COPD, PE, thyroid disease and lymphoma, than did the comparison cohort
Summary
Respiratory failure (RF) remains a common reason for admission to intensive care units (ICUs) [1]. RF is a syndrome characterized by the failure of one or both gas exchange functions of the respiratory system, namely oxygenation and carbon dioxide elimination. RF is diagnosed when the arterial oxygen tension (PaO2) is ,60 mmHg while breathing air (hypoxemia) or when the arterial carbon dioxide tension (PaCO2) is. mm (hypercapnia) [2]. The hypoxemia may be accompanied by hypercapnia. RF may be an acute RF (ARF) or a chronic RF.. RF can arise from an abnormality in any of the components of the respiratory system, including the airways, alveoli, interstitia, and vessels [2,3]. The mortality rate of ARF in critically ill patients is between 40% and 65% [4]
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