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Risks, subtypes, and hospitalization costs of stroke among patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan.
J Rheumatol 2012; 39(8):1611-8JR

Abstract

OBJECTIVE

To compare risks, subtypes, and hospitalization costs of stroke between cohorts with and without systemic lupus erythematosus (SLE).

METHODS

From the catastrophic illnesses registry of Taiwan's universal health insurance claims data, we identified 13,689 patients with SLE diagnosed in 1997-2008 and selected 54,756 non-SLE controls, frequency-matched with age (every 5 years), sex, and index year. Age-specific and type-specific stroke incidence, hazard, and cost of stroke were compared between the 2 cohorts to the end of 2008.

RESULTS

Compared with the non-SLE cohort, the risk of stroke was 3.2-fold higher in the SLE cohort (5.53 vs 1.74 per 1000 person-years) with an overall adjusted HR of 2.90 (95% CI 2.52-3.33). The age-specific risk was the highest in patients 1-17 years old (HR 163, 95% CI 22.2-1197) and decreased as age increased (p = 0.004). Hypertension and renal disease were the most important comorbidities in the SLE cohort predicting stroke risk (HR 1.75, 95% CI 1.28-2.39 and HR 1.66, 95% CI 1.32-2.10, respectively). There were more hemorrhagic strokes in the SLE cohort than in the non-SLE cohort, but not significantly (28.0% vs 23.4%; p = 0.10). The hospitalization cost for stroke patients was more than twice the cost for those with SLE than for those without (p < 0.0001).

CONCLUSION

Stroke risk and hospital care costs are considerably greater for patients with SLE than without. The relative risk of stroke is the highest in young patients with SLE.

Authors+Show Affiliations

China Medical University College of Public Health, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22753653

Citation

Wang, I-Kuan, et al. "Risks, Subtypes, and Hospitalization Costs of Stroke Among Patients With Systemic Lupus Erythematosus: a Retrospective Cohort Study in Taiwan." The Journal of Rheumatology, vol. 39, no. 8, 2012, pp. 1611-8.
Wang IK, Muo CH, Chang YC, et al. Risks, subtypes, and hospitalization costs of stroke among patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan. J Rheumatol. 2012;39(8):1611-8.
Wang, I. K., Muo, C. H., Chang, Y. C., Liang, C. C., Lin, S. Y., Chang, C. T., ... Sung, F. C. (2012). Risks, subtypes, and hospitalization costs of stroke among patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan. The Journal of Rheumatology, 39(8), pp. 1611-8. doi:10.3899/jrheum.111510.
Wang IK, et al. Risks, Subtypes, and Hospitalization Costs of Stroke Among Patients With Systemic Lupus Erythematosus: a Retrospective Cohort Study in Taiwan. J Rheumatol. 2012;39(8):1611-8. PubMed PMID: 22753653.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risks, subtypes, and hospitalization costs of stroke among patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan. AU - Wang,I-Kuan, AU - Muo,Chih-Hsin, AU - Chang,Yi-Chih, AU - Liang,Chih-Chia, AU - Lin,Shih-Yi, AU - Chang,Chiz-Tzung, AU - Yen,Tzung-Hai, AU - Chuang,Feng-Rong, AU - Chen,Pei-Chun, AU - Huang,Chiu-Ching, AU - Sung,Fung-Chang, Y1 - 2012/07/01/ PY - 2012/7/4/entrez PY - 2012/7/4/pubmed PY - 2013/1/17/medline SP - 1611 EP - 8 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 39 IS - 8 N2 - OBJECTIVE: To compare risks, subtypes, and hospitalization costs of stroke between cohorts with and without systemic lupus erythematosus (SLE). METHODS: From the catastrophic illnesses registry of Taiwan's universal health insurance claims data, we identified 13,689 patients with SLE diagnosed in 1997-2008 and selected 54,756 non-SLE controls, frequency-matched with age (every 5 years), sex, and index year. Age-specific and type-specific stroke incidence, hazard, and cost of stroke were compared between the 2 cohorts to the end of 2008. RESULTS: Compared with the non-SLE cohort, the risk of stroke was 3.2-fold higher in the SLE cohort (5.53 vs 1.74 per 1000 person-years) with an overall adjusted HR of 2.90 (95% CI 2.52-3.33). The age-specific risk was the highest in patients 1-17 years old (HR 163, 95% CI 22.2-1197) and decreased as age increased (p = 0.004). Hypertension and renal disease were the most important comorbidities in the SLE cohort predicting stroke risk (HR 1.75, 95% CI 1.28-2.39 and HR 1.66, 95% CI 1.32-2.10, respectively). There were more hemorrhagic strokes in the SLE cohort than in the non-SLE cohort, but not significantly (28.0% vs 23.4%; p = 0.10). The hospitalization cost for stroke patients was more than twice the cost for those with SLE than for those without (p < 0.0001). CONCLUSION: Stroke risk and hospital care costs are considerably greater for patients with SLE than without. The relative risk of stroke is the highest in young patients with SLE. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/22753653/Risks_subtypes_and_hospitalization_costs_of_stroke_among_patients_with_systemic_lupus_erythematosus:_a_retrospective_cohort_study_in_Taiwan_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&amp;pmid=22753653 DB - PRIME DP - Unbound Medicine ER -