SYSTEMIC SCLEROSIS WITH LUNG INVOLVEMENT INCREASES INPATIENT MORTALITY: ANALYSIS OF THE NATIONAL INPATIENT SAMPLE

Abstract

SESSION TITLE: Pulmonary Manifestations of Systemic Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Analyze the outcomes of Systemic Sclerosis (SSc) with and without lung involvement. The primary outcome was inpatient mortality, while secondary outcomes were hospital length of stay (LOS) and total hospital charge. METHODS: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. This database is the largest collection of inpatient hospitalization data in the United States. It is a nationally representative sample of 20% of hospitalizations from approximately 1000 hospitals. The numbers in the databases are weighted to optimize national estimates. The NIS was searched for SSc hospitalizations (“M34”) with lung involvement (“M34.81”) and without lung involvement as principal or secondary diagnosis using the ICD-10 codes above. SSc hospitalizations for patients aged≥ 18 years from the above groups were identified. Multivariate logistic and linear regression analysis was used to adjust for possible confounders for the primary and secondary outcomes respectively. RESULTS: There were over 71 million discharges included in the combined 2016 and 2017 NIS database. 62930 hospitalizations were for adult patients (aged 18 years or above), who had either a principal or secondary ICD 10 code for SSc. 5095 (8.10%) and 57835 (91.90%) of these hospitalizations were for SSc with lung and without lung involvement respectively. The mean age for SSc with lung involvement was 59.91 vs 62.95 years without lung involvement (P=0.000). 2980 adult SSc hospitalizations (4.74%) resulted in inpatient mortality. 460 (15.44%) of the deaths occurred in SSc with lung involvement vs 2520 (84.56%) without lung involvement (P=0.000). The adjusted odds ratio (AOR) for inpatient mortality for SSc with lung compared to without lung involvement was 2.29 (95% CI 1.78-2.94, P=0.000). Mean LOS of hospitalization for SSc with lung involvement was 8.38 vs 5.97 days without lung involvement. SSc with lung involvement hospitalizations had a mean increase in adjusted LOS of 1.94 days (95% CI 1.11-2.76, P=0.000) compared to without lung involvement. Total hospital charges for SSc with lung involvement was $109565 vs $65187 for without lung involvement. SSc with lung involvement hospitalizations had an increase in adjusted mean total hospital charge of $33332 compared to without lung involvement (95% CI 16199-50465, P=0.000). CONCLUSIONS: Hospitalizations for SSc with lung involvement have both statistical and clinically significant increased inpatient mortality, LOS and total hospital charge compared to those without lung involvement. CLINICAL IMPLICATIONS: SSc with lung involvement are more likely to experience inpatient death, have greater LOS and hospital charge compared to without lung involvement A collaborative approach between the rheumatologist and pulmonologist is needed to ensure the best possible outcomes for these hospitalizations. DISCLOSURES: No relevant relationships by Ehizogie Edigin, source=Web Response No relevant relationships by VICTOR PRADO, source=Web Response No relevant relationships by Miguel Salazar, source=Web Response No relevant relationships by Hafeez Shaka, source=Web Response