TY - JOUR
T1 - Sex-Specific Outcomes of Acute Stroke in Patients with Systemic Lupus Erythematosus
T2 - A National Inpatient Sample Study
AU - Pana, Tiberiu A.
AU - Jesenakova, Sona
AU - Carter, Ben
AU - Hollick, Rosemary
AU - Mohamed, Mohamed O.
AU - Mamas, Mamas A.
AU - Myint, Phyo K.
N1 - Funding Information:
S.J. received the INSPIRE Scholarship as a part of the Aberdeen Summer Research Scholarship Programme of the Aberdeen Clinical Academic Training (ACAT) Pathways. The INSPIRE Scholarship is funded by The INSPIRE Scheme of the Academy of Medical Sciences. This paper represents an independent research part funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London (BC).
Publisher Copyright:
© 2023 by the authors.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder associated with increased stroke risk. Its association with stroke outcomes remains poorly understood. In this study, we aimed to compare the sex-specific SLE-associated acute stroke outcomes. Methods: Stroke hospitalisations between 2015 and 2018 from the National Inpatient Sample were analysed. The associations between SLE and outcomes (inpatient mortality, length-of-stay > 4 days and routine discharge) were examined using multivariable logistic regressions, stratifying by sex and adjusting for age, race, stroke type, revascularisation, hospital characteristics and comorbidities. Results: A total of 316,531 records representing 1,581,430 hospitalisations were included. Median (interquartile range) age was 71 (60–82) years. There were 940 (0.06%) males and 6110 (0.39%) females with SLE. There were no associations between SLE and mortality amongst either females (odds ratio (95% confidence interval) = 1.11 (0.84–1.48)) or males (0.81 (0.34–1.94)). Nevertheless, SLE was associated with prolonged hospitalisation (1.17 (1.03–1.32)) and lower odds of routine discharge (0.82 (0.72–0.94)) amongst females. There were no associations between SLE and other adverse outcomes amongst males. Conclusions: The association between SLE and acute stroke outcomes was influenced by sex. While SLE was not associated with mortality in either sex, females with SLE had higher odds of prolonged hospitalisation and lower odds of routine home discharge compared to patients without SLE, while males did not exhibit this increased risk.
AB - Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder associated with increased stroke risk. Its association with stroke outcomes remains poorly understood. In this study, we aimed to compare the sex-specific SLE-associated acute stroke outcomes. Methods: Stroke hospitalisations between 2015 and 2018 from the National Inpatient Sample were analysed. The associations between SLE and outcomes (inpatient mortality, length-of-stay > 4 days and routine discharge) were examined using multivariable logistic regressions, stratifying by sex and adjusting for age, race, stroke type, revascularisation, hospital characteristics and comorbidities. Results: A total of 316,531 records representing 1,581,430 hospitalisations were included. Median (interquartile range) age was 71 (60–82) years. There were 940 (0.06%) males and 6110 (0.39%) females with SLE. There were no associations between SLE and mortality amongst either females (odds ratio (95% confidence interval) = 1.11 (0.84–1.48)) or males (0.81 (0.34–1.94)). Nevertheless, SLE was associated with prolonged hospitalisation (1.17 (1.03–1.32)) and lower odds of routine discharge (0.82 (0.72–0.94)) amongst females. There were no associations between SLE and other adverse outcomes amongst males. Conclusions: The association between SLE and acute stroke outcomes was influenced by sex. While SLE was not associated with mortality in either sex, females with SLE had higher odds of prolonged hospitalisation and lower odds of routine home discharge compared to patients without SLE, while males did not exhibit this increased risk.
KW - sex differences
KW - stroke
KW - systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=85146760167&partnerID=8YFLogxK
U2 - 10.3390/jcm12020462
DO - 10.3390/jcm12020462
M3 - Article
AN - SCOPUS:85146760167
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 2
M1 - 462
ER -