Effect of Systemic Lupus Erythematosus on the Risk of Incident Respiratory Failure: A National Cohort Study

Abstract

PurposeWe conducted a nationwide cohort study to investigate the relationship between systemic lupus erythematosus (SLE) and the risk of incident respiratory failure.MethodsFrom the National Health Insurance Research Database, we identified 11 533 patients newly diagnosed with SLE and 46 132 controls without SLE who were randomly selected through frequency-matching according to age, sex, and index year. Both cohorts were followed until the end of 2011 to measure the incidence of incident respiratory failure, which was compared between the 2 cohorts through a Cox proportional hazards regression analysis.ResultsThe adjusted hazard ratio (aHR) of incident respiratory failure was 5.80 (95% confidence interval [CI] = 5.15–6.52) for the SLE cohort after we adjusted for sex, age, and comorbidities. Both men (aHR = 3.44, 95% CI = 2.67–4.43) and women (aHR = 6.79, 95% CI = 5.93–7.77) had a significantly higher rate of incident respiratory failure in the SLE cohort than in the non-SLE cohort. Both men and women aged <35 years (aHR = 31.2, 95% CI = 21.6–45.2), 35–65 years; (aHR = 6.19, 95% CI = 5.09–7.54) and ≥65 years (aHR = 2.35, 95% CI = 1.92–2.87) had a higher risk of incident respiratory failure in the SLE cohort. Moreover, the risk of incident respiratory failure was higher in the SLE cohort than the non-SLE cohort, for subjects with (aHR = 2.65, 95% CI = 2.22–3.15) or without (aHR = 9.08, 95% CI = 7.72–10.7) pre-existing comorbidities. In the SLE cohort, subjects with >24 outpatient visits and hospitalizations per year had a higher incident respiratory failure risk (aHR = 21.7, 95% CI = 18.0–26.1) compared with the non-SLE cohort.ConclusionPatients with SLE are associated with an increased risk of incident respiratory failure, regardless of their age, sex, and pre-existing comorbidities; especially medical services with higher frequency.

Association of asthma–chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia and heart failure: a population-based retrospective cohort study

“…Comorbidities, such as atherosclerosis-related diseases 12 (eg, diabetes, hypertension and hyperlipidaemia; all p<0.05) and hypoxaemia-related diseases 27 (eg, pneumonia; p<0.05), were associated with the risk of CVDs (eg, CAD 7 ) in the current study; this finding is also consistent with those of previous studies. 7 11 12 …”

“… 3 From a biological viewpoint, several studies have reported an association between increased levels of inflammatory markers (eg, cytokine) and an increased risk of CVDs, including CAD, 31 CD 32 and HF. 33 Taken together, these findings may support the association with CVDs 34 of systemic pulmonary vessel 35 (eg, the pulmonary artery 7 ) and airway inflammation 3 accompanied by hypoxaemia 36 and atherosclerosis 12 of the vessel 11 in ACOS, 7 as observed in younger adults in the present study (age ≥40 to <65 years; p<0.05 for CAD, CD and HF, except for CD (age 40–49 years, p>0.05)). Meanwhile, patients without AE-COPD who were in the ACOS cohort (aHRs for CAD, CD and HF=1.85, 1.57 and 2.07, respectively; all p<0.05) were still associated with the risk of CVDs; this result is consistent with that of a previous study.…”

“… 10 These complications are associated with atherosclerosis 11 and CVDs. 12 Therefore, the incidence of HF increases with an increase in the incidence of CD. In addition, the use of a bronchodilator is associated with CAD and HF.…”

Effect of the asthma-chronic obstructive pulmonary disease syndrome on the stroke, Parkinson's disease, and dementia: a national cohort study

“…The LHID2000 randomly selected 1,000,000 insurants enrolled in the NHI program from 1996 to 2000 and traced their medical utilization. Details of the LHID2000 and NHI program have been described elsewhere [ 82 ].…”

Increased risk of dental trauma in patients with allergic rhinitis: A nationwide population-based cohort study

“…The NHIRD encrypts patients’ personal information to protect privacy, and provided researchers with anonymous identification numbers associated with relevant claims information, including the patient’s sex, date of birth, medical services received, and prescriptions. Therefore, patient consent was not required to access the NHIRD [ 23 ].…”