Characteristics of comorbidities and costs among patients who died from systemic lupus erythematosus in Taiwan

Shih Chao Kang, Shinn Jang Hwang, Yu Sheng Chang, Chung Tei Chou, Chang Youh Tsai

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction: Systemic lupus erythematosus (SLE) is prevalent among young female adults, particularly in Asia. In Taiwan, features of end-of-life SLE patients remain unclear. Material and methods: Data regarding SLE patients whose hospitalization ended up with death were collected and analyzed from the repository of the National Health Insurance Research Database, Taiwan, from 2005 to 2007. Results: A total of 302 subjects were enrolled and the majority of these were young to middle-aged women (45.8 ±18.5 years); only one third of them were treated by rheumatologists. Eight patients (2.6%) with comorbid cancers received hospice care. Sepsis/bacteremia (42.1%) was the major acute comorbidity. Nephropathy/nephritis (35.1%) represented the major chronic comorbidity. Among 27 subjects with comorbid cancers, gynecological cancers were the most common (18%). Among the inpatient costs, the cost of prescriptions accounted for the majority (21.7 ±11.5%). Under a multivariate logistic regression, advanced age (≥ 65 years) correlated positively with acute lower respiratory conditions (ALRC) and diabetes mellitus (DM), and male gender correlated negatively with nephropathy/nephritis. The nephropathy/nephritis correlated positively with hospital stays > 14 days. The ALRC was closely associated with acute respiratory failure, but not with shock. However, shock was closely associated with hospital stays ≤ 14 days and sepsis/bacteremia. Cancer development was inversely correlated to nephropathy/nephritis, acute respiratory failure, and shock (all p <0.05). Conclusions: The end-of-life SLE patients revealed aforementioned characteristics and relationships. Sepsis/bacteremia, acute respiratory failure, and ALRC contributed most frequently to the ultimate death of acutely ill SLE patients.

Original languageEnglish
Pages (from-to)690-696
Number of pages7
JournalArchives of Medical Science
Volume8
Issue number4
DOIs
Publication statusPublished - Aug 2012
Externally publishedYes

Fingerprint

Taiwan
Systemic Lupus Erythematosus
Nephritis
Comorbidity
Costs and Cost Analysis
Bacteremia
Respiratory Insufficiency
Shock
Sepsis
Length of Stay
Neoplasms
Hospice Care
National Health Programs
Prescriptions
Inpatients
Young Adult
Diabetes Mellitus
Hospitalization
Logistic Models
Databases

Keywords

  • Comorbidity
  • Impending death
  • Retrospective study
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Characteristics of comorbidities and costs among patients who died from systemic lupus erythematosus in Taiwan. / Kang, Shih Chao; Hwang, Shinn Jang; Chang, Yu Sheng; Chou, Chung Tei; Tsai, Chang Youh.

In: Archives of Medical Science, Vol. 8, No. 4, 08.2012, p. 690-696.

Research output: Contribution to journalArticle

Kang, Shih Chao ; Hwang, Shinn Jang ; Chang, Yu Sheng ; Chou, Chung Tei ; Tsai, Chang Youh. / Characteristics of comorbidities and costs among patients who died from systemic lupus erythematosus in Taiwan. In: Archives of Medical Science. 2012 ; Vol. 8, No. 4. pp. 690-696.
@article{531d1ff7a40a491bb457fa1d252ccfc5,
title = "Characteristics of comorbidities and costs among patients who died from systemic lupus erythematosus in Taiwan",
abstract = "Introduction: Systemic lupus erythematosus (SLE) is prevalent among young female adults, particularly in Asia. In Taiwan, features of end-of-life SLE patients remain unclear. Material and methods: Data regarding SLE patients whose hospitalization ended up with death were collected and analyzed from the repository of the National Health Insurance Research Database, Taiwan, from 2005 to 2007. Results: A total of 302 subjects were enrolled and the majority of these were young to middle-aged women (45.8 ±18.5 years); only one third of them were treated by rheumatologists. Eight patients (2.6{\%}) with comorbid cancers received hospice care. Sepsis/bacteremia (42.1{\%}) was the major acute comorbidity. Nephropathy/nephritis (35.1{\%}) represented the major chronic comorbidity. Among 27 subjects with comorbid cancers, gynecological cancers were the most common (18{\%}). Among the inpatient costs, the cost of prescriptions accounted for the majority (21.7 ±11.5{\%}). Under a multivariate logistic regression, advanced age (≥ 65 years) correlated positively with acute lower respiratory conditions (ALRC) and diabetes mellitus (DM), and male gender correlated negatively with nephropathy/nephritis. The nephropathy/nephritis correlated positively with hospital stays > 14 days. The ALRC was closely associated with acute respiratory failure, but not with shock. However, shock was closely associated with hospital stays ≤ 14 days and sepsis/bacteremia. Cancer development was inversely correlated to nephropathy/nephritis, acute respiratory failure, and shock (all p <0.05). Conclusions: The end-of-life SLE patients revealed aforementioned characteristics and relationships. Sepsis/bacteremia, acute respiratory failure, and ALRC contributed most frequently to the ultimate death of acutely ill SLE patients.",
keywords = "Comorbidity, Impending death, Retrospective study, Systemic lupus erythematosus",
author = "Kang, {Shih Chao} and Hwang, {Shinn Jang} and Chang, {Yu Sheng} and Chou, {Chung Tei} and Tsai, {Chang Youh}",
year = "2012",
month = "8",
doi = "10.5114/aoms.2012.30293",
language = "English",
volume = "8",
pages = "690--696",
journal = "Archives of Medical Science",
issn = "1734-1922",
publisher = "Termedia Publishing House Ltd.",
number = "4",

}

TY - JOUR

T1 - Characteristics of comorbidities and costs among patients who died from systemic lupus erythematosus in Taiwan

AU - Kang, Shih Chao

AU - Hwang, Shinn Jang

AU - Chang, Yu Sheng

AU - Chou, Chung Tei

AU - Tsai, Chang Youh

PY - 2012/8

Y1 - 2012/8

N2 - Introduction: Systemic lupus erythematosus (SLE) is prevalent among young female adults, particularly in Asia. In Taiwan, features of end-of-life SLE patients remain unclear. Material and methods: Data regarding SLE patients whose hospitalization ended up with death were collected and analyzed from the repository of the National Health Insurance Research Database, Taiwan, from 2005 to 2007. Results: A total of 302 subjects were enrolled and the majority of these were young to middle-aged women (45.8 ±18.5 years); only one third of them were treated by rheumatologists. Eight patients (2.6%) with comorbid cancers received hospice care. Sepsis/bacteremia (42.1%) was the major acute comorbidity. Nephropathy/nephritis (35.1%) represented the major chronic comorbidity. Among 27 subjects with comorbid cancers, gynecological cancers were the most common (18%). Among the inpatient costs, the cost of prescriptions accounted for the majority (21.7 ±11.5%). Under a multivariate logistic regression, advanced age (≥ 65 years) correlated positively with acute lower respiratory conditions (ALRC) and diabetes mellitus (DM), and male gender correlated negatively with nephropathy/nephritis. The nephropathy/nephritis correlated positively with hospital stays > 14 days. The ALRC was closely associated with acute respiratory failure, but not with shock. However, shock was closely associated with hospital stays ≤ 14 days and sepsis/bacteremia. Cancer development was inversely correlated to nephropathy/nephritis, acute respiratory failure, and shock (all p <0.05). Conclusions: The end-of-life SLE patients revealed aforementioned characteristics and relationships. Sepsis/bacteremia, acute respiratory failure, and ALRC contributed most frequently to the ultimate death of acutely ill SLE patients.

AB - Introduction: Systemic lupus erythematosus (SLE) is prevalent among young female adults, particularly in Asia. In Taiwan, features of end-of-life SLE patients remain unclear. Material and methods: Data regarding SLE patients whose hospitalization ended up with death were collected and analyzed from the repository of the National Health Insurance Research Database, Taiwan, from 2005 to 2007. Results: A total of 302 subjects were enrolled and the majority of these were young to middle-aged women (45.8 ±18.5 years); only one third of them were treated by rheumatologists. Eight patients (2.6%) with comorbid cancers received hospice care. Sepsis/bacteremia (42.1%) was the major acute comorbidity. Nephropathy/nephritis (35.1%) represented the major chronic comorbidity. Among 27 subjects with comorbid cancers, gynecological cancers were the most common (18%). Among the inpatient costs, the cost of prescriptions accounted for the majority (21.7 ±11.5%). Under a multivariate logistic regression, advanced age (≥ 65 years) correlated positively with acute lower respiratory conditions (ALRC) and diabetes mellitus (DM), and male gender correlated negatively with nephropathy/nephritis. The nephropathy/nephritis correlated positively with hospital stays > 14 days. The ALRC was closely associated with acute respiratory failure, but not with shock. However, shock was closely associated with hospital stays ≤ 14 days and sepsis/bacteremia. Cancer development was inversely correlated to nephropathy/nephritis, acute respiratory failure, and shock (all p <0.05). Conclusions: The end-of-life SLE patients revealed aforementioned characteristics and relationships. Sepsis/bacteremia, acute respiratory failure, and ALRC contributed most frequently to the ultimate death of acutely ill SLE patients.

KW - Comorbidity

KW - Impending death

KW - Retrospective study

KW - Systemic lupus erythematosus

UR - http://www.scopus.com/inward/record.url?scp=84866870784&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866870784&partnerID=8YFLogxK

U2 - 10.5114/aoms.2012.30293

DO - 10.5114/aoms.2012.30293

M3 - Article

C2 - 23056082

AN - SCOPUS:84866870784

VL - 8

SP - 690

EP - 696

JO - Archives of Medical Science

JF - Archives of Medical Science

SN - 1734-1922

IS - 4

ER -