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Risks, subtypes, and hospitalization costs of stroke among patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan.

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.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    China Medical University College of Public Health, Taichung, Taiwan.

    , , , , , , , , ,

    Source

    The Journal of rheumatology 39:8 2012 Aug pg 1611-8

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Child
    Child, Preschool
    Comorbidity
    Databases, Factual
    Female
    Health Care Costs
    Hospitalization
    Humans
    Incidence
    Infant
    Lupus Erythematosus, Systemic
    Male
    Middle Aged
    Registries
    Retrospective Studies
    Risk
    Stroke
    Taiwan

    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 -