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Hepatic involvement, vasculitis, disease activity linked to hospitalizations of patients with pSS
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Patients with primary Sjögren’s syndrome were at higher risk for hospitalization in the presence of hepatic involvement, vasculitis and high disease activity, according to recently published research.
A group of 170 patients with primary Sjögren’s syndrome (pSS) who attended a tertiary care center in Mexico City between January 2000 and April 2013 were consecutively recruited. Demographics, disease duration, the presence of ocular or oral involvement and extraglandular involvement, including nonerosive arthritis, Raynaud’s syndrome, vasculitis and lung, liver or other organ involvement and additional data were retrospectively collected. Serological data, including the presence of rheumatoid factor, antinuclear antibodies, cryoglobulins, complement and other data were collected. Comorbidity data and use of prednisone and immunosuppressants were recorded for statistical analysis.
Hospitalizations occurred 111 times by 55 patients during the study period with a median length of stay of 9 days. The cumulative incidence of hospital stays was 32.3% and occurred at a rate of 6.49 per 100 patient-years.
The most common causes of hospitalization were disease activity in 37 patients (33.3%) and infection in 36 patients (32.4%). Other causes included neoplasia, cardiovascular disease, hepatic disease and others. The most common infections were related to bacterial pneumonia (30%) and urinary tract infections (16.6%). Other infections related to hospitalization included herpes zoster, cellulitis, gastroenteritis, varicella zoster virus, influenza, tuberculosis and septic shock.
The most common causes of hospitalization related to disease activity were in eight patients with peripheral nervous system involvement and in six patients with central nervous system involvement. patients had two overlapping causes of hospitalization.
Multivariate analysis showed hepatic involvement, the presence of vasculitis and high disease activity were positively correlated with hospitalizations, while the use of antimalarial drugs had a negative association. No serological variables were associated with the risk for hospitalization. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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