ILD decreasing as cause of hospitalization, mortality in SSc

Hospital admission and mortality related to interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) decreased over a 10-year period, according to a study. Infection, most often pneumonia, was the main cause of acute hospitalization and mortality.

In this retrospective analysis, all acute hospital admissions from a cohort of 95 patients with SSc from a single center over 10 years (2010-2020) were analyzed. During this time, the center treated 123 patients with SSc, 53 of whom required acute hospitalization for a total of 164 admissions.

Infectious disease was the most frequent reason for admission (27%), with the majority (70%) having pneumonia. Of the patients with pneumonia, 74% had SSc-associated ILD. Approximately 70% of patients admitted due to infection were immunosuppressed at the time of the hospitalization.

Other frequent causes for hospital admission included cardiac disease (16.5%), peripheral vascular disease (12.8%), pulmonary hypertension (9.8%), and ILD (9.1%).

Over the 10-year study period, admissions due to cardiac disease increased whereas, over the last 5 years of the study period, admissions due to ILD decreased.

There was an in-hospital mortality rate of 9%. Of the 14 patients that died, 36% were due to pneumonia, 21% due to heart failure, 21% due to neoplastic diseases, 14% due to pulmonary hypertension, and 7% due to ILD.

Gender, race, digital ulcers, cardiac dysfunction, ILD, and pulmonary hypertension were factors associated with acute admissions and mortality.

Reference
Caetano J, Batista F, Amaral MC, et al. Acute hospitalization in a cohort of patients with systemic sclerosis: a 10-year retrospective cohort study. Rheumatol Int. 2021; https://doi.org/10.1007/s00296-021-04983-4