Comorbidities associated with Sjögren's syndrome: Results from the Nationwide Inpatient Sample.

Authors

  • Terah Koch Nationwide Children's Hospital, Columbus, OH 43205
  • Ibtisam Al-Hashimi Texas A&M University Baylor College of Dentistry, Dallas, TX 75246
  • Boyd M. Koffman Department of Neurology, University of Toledo Health Science Campus, Toledo, OH 43614
  • Abhishek Deshpande Case Western Reserve University School of Medicine, Cleveland OH 44106
  • Sadik A. Khuder University of Toledo Health Science Campus, Toledo, OH 43614

DOI:

https://doi.org/10.46570/utjms.vol1-2014-74

Keywords:

Sjögren’s syndrome, autoimmune diseases, comorbidities, HCUP data

Abstract

Although multiple comorbidities associated with Sjögren’s syndrome (SS) have been reported, reliable data regarding the prevalence of specific comorbidities among patients with SS remain sparse. In this study, we investigated the prevalence and risk for a broad spectrum of medical conditions among patients with SS in the United States. The Health Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) data was utilized in order to investigate 29 different comorbidities among SS patients. Between the years 2007 to 2009 there were 19,127 admissions with SS listed as principal diagnosis (1.3%) and secondary diagnosis (98.7%). Compared with 57,381 controls, SS patients had significantly higher prevalence of lymphoma (OR 1.6), valvular disease (OR 1.42), congestive heart failure (OR 1.28), hypothyroidism (OR 1.24), paralysis (OR 1.24), deficiency anemia (OR 1.16), depression (OR 1.18), neurological disorders (OR 1.17), and chronic pulmonary disease (OR 1.07). SS is associated with substantial medical conditions that may impact morbidity and mortality as well as quality of life for individuals suffering from SS.

Author Biographies

Terah Koch, Nationwide Children's Hospital, Columbus, OH 43205

Research Associate

Ibtisam Al-Hashimi, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246

Professor, Department of Periodontics

Boyd M. Koffman, Department of Neurology, University of Toledo Health Science Campus, Toledo, OH 43614

Professor, Department of Neurology

Abhishek Deshpande, Case Western Reserve University School of Medicine, Cleveland OH 44106

Department of medicine

Sadik A. Khuder, University of Toledo Health Science Campus, Toledo, OH 43614

Professor, Department of Medicine

References

Fox, R.I. (2005) Sjögren’s syndrome. Lancet 366, 321-331. DOI: https://doi.org/10.1016/S0140-6736(05)66990-5

Kassan, S.S. (2004) Moutsopoulos HM. Clinical manifestations and early diagnosis of Sjögren's syndrome. Arch Intern Med 164(12), 1275-84. DOI: https://doi.org/10.1001/archinte.164.12.1275

Valim, V., Zandonade, E., Pereira, A.M., de Brito Filho, O.H., Serrano, E.V., Musso, C., Giovelli, R.A., and Ciconelli, R.M. (2013) Primary Sjögren’s syndrome prevalence in a major metropolitan area in Brazil. Revista brasileira de reumatologia 53, 24-34. DOI: https://doi.org/10.1016/S2255-5021(13)70003-8

Somers, E.C., Thomas, S.L., Smeeth, L., and Hall, A.J. (2006) Autoimmune diseases co-occurring within individuals and within families: a systematic review. Epidemiology (Cambridge, Mass.) 17, 202-217. DOI: https://doi.org/10.1097/01.ede.0000193605.93416.df

Somers, E.C., Thomas, S.L., Smeeth, L., and Hall, A.J. (2009) Are individuals with an autoimmune disease at higher risk of a second autoimmune disorder? American journal of epidemiology 169, 749-755. DOI: https://doi.org/10.1093/aje/kwn408

Kang JH, L.H. (2010) Comorbidities in patients with Primary Sjögren’s Syndrome: A Registry-based Case-control Study. J Rheumatol 37, 1188-1194. DOI: https://doi.org/10.3899/jrheum.090942

Baldini, C., Pepe, P., Luciano, N., Ferro, F., Talarico, R., Grossi, S., Tavoni, A., and Bombardieri, S. (2012) A clinical prediction rule for lymphoma development in primary Sjögren’s syndrome. J Rheumatol 39, 804-808. DOI: https://doi.org/10.3899/jrheum.110754

Johnsen, S.J., Brun, J.G., Goransson, L.G., Smastuen, M.C., Johannesen, T.B., Haldorsen, K., Harboe, E., Jonsson, R., Meyer, P.A., and Omdal, R. (2013) Risk of non-Hodgkin's lymphoma in primary Sjögren’s syndrome: a population-based study. Arthritis care & research 65, 816-821. DOI: https://doi.org/10.1002/acr.21887

Szodoray, P., Barta, Z., Lakos, G., Szakall, S., and Zeher, M. (2004) Coeliac disease in Sjögren’s syndrome--a study of 111 Hungarian patients. Rheumatology international 24, 278-282. DOI: https://doi.org/10.1007/s00296-003-0360-x

Yoshikawa, K., Hatate, J., Toratani, N., Sugiura, S., Shimizu, Y., Takahash, T., Ito, T., and Fukunaga, R. (2012) Prevalence of Sjögren’s syndrome with dementia in a memory clinic. Journal of the neurological sciences 322, 217-221. DOI: https://doi.org/10.1016/j.jns.2012.07.060

Gaches, F., Delaire, L., Nadalon, S., Loustaud-Ratti, V., and Vidal, E. (1998) [Frequency of autoimmune diseases in 218 patients with autoimmune thyroid pathologies]. La Revue de medecine interne / fondee ... par la Societe nationale francaise de medecine interne 19, 173-179. DOI: https://doi.org/10.1016/S0248-8663(97)80716-3

Inal, V., Kitapcioglu, G., Karabulut, G., Keser, G., and Kabasakal, Y. (2010) Evaluation of quality of life in relation to anxiety and depression in primary Sjögren’s syndrome. Modern rheumatology / the Japan Rheumatism Association 20, 588-597. DOI: https://doi.org/10.3109/s10165-010-0329-z

The Healthcare Cost and Utilization Project (HCUP). [cited 2013 Janurary 15]; Available from: .

Alamanos, Y., Tsifetaki, N., Voulgari, P.V., Venetsanopoulou, A.I., Siozos, C., and Drosos, A.A. (2006) Epidemiology of primary Sjögren’s syndrome in north-west Greece, 1982-2003. Rheumatology (Oxford) 45, 187-191. DOI: https://doi.org/10.1093/rheumatology/kei107

Andonopoulos, A.P., Drosos, A.A., Skopouli, F.N., Acritidis, N.C., and Moutsopoulos, H.M. (1987) Secondary Sjögren’s syndrome in rheumatoid arthritis. J Rheumatol 14, 1098-1103.

Ohara, T., Itoh, Y., and Itoh, K. (2000) Reevaluation of laboratory parameters in relation to histological findings in primary and secondary Sjögren’s syndrome. Internal medicine (Tokyo, Japan) 39, 457-463. DOI: https://doi.org/10.2169/internalmedicine.39.457

Zhou, J.G., Qing, Y.F., Jiang, L., Yang, Q.B., and Luo, W.F. (2010) Clinical analysis of primary Sjögren’s syndrome complicating anemia. Clinical rheumatology 29, 525-529. DOI: https://doi.org/10.1007/s10067-009-1366-x

Theander, E., Henriksson, G., Ljungberg, O., Mandl, T., Manthorpe, R., and Jacobsson, L.T. (2006) Lymphoma and other malignancies in primary Sjögren’s syndrome: a cohort study on cancer incidence and lymphoma predictors. Annals of the rheumatic diseases 65, 796-803. DOI: https://doi.org/10.1136/ard.2005.041186

Solans-Laque, R., Lopez-Hernandez, A., Bosch-Gil, J.A., Palacios, A., Campillo, M., and Vilardell-Tarres, M. (2011) Risk, predictors, and clinical characteristics of lymphoma development in primary Sjögren’s syndrome. Seminars in arthritis and rheumatism 41, 415-423. DOI: https://doi.org/10.1016/j.semarthrit.2011.04.006

Dong, L., Chen, Y., Masaki, Y., Okazaki, T., and Umehara, H. (2013) Possible Mechanisms of Lymphoma Development in Sjögren’s Syndrome. Current immunology reviews 9, 13-22. DOI: https://doi.org/10.2174/1573395511309010003

Vassiliou, V.A., Moyssakis, I., Boki, K.A., and Moutsopoulos, H.M. (2008) Is the heart affected in primary Sjögren’s syndrome? An echocardiographic study. Clinical and experimental rheumatology 26, 109-112.

Al-Hashimi, I., Khuder, S., and Haghighat, N. (2001) Frequency and predictive value of the clinical manifestations in Sjögren’s syndrome. Journal of Oral Pathology and Medicine 30: 1-6. DOI: https://doi.org/10.1034/j.1600-0714.2001.300101.x

Alfaris, N., Curiel, R., Tabbara, S., and Irwig, M.S. (2010) Autoimmune thyroid disease and Sjogren syndrome. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases 16, 146-147. DOI: https://doi.org/10.1097/RHU.0b013e3181d52a28

Westhoff, G., Dorner, T., and Zink, A. (2012) Fatigue and depression predict physician visits and work disability in women with primary Sjögren’s syndrome: results from a cohort study. Rheumatology (Oxford) 51, 262-269. DOI: https://doi.org/10.1093/rheumatology/ker208

Valtysdottir, S.T., Gudbjörnsson, B., Lindqvist, U., Hallgren, R. and Hetta, J. (2000) Anxiety and depression in in patients with primary Sjögren’s syndrome. Journal of Rheumatology 27, 165-169.

Spezialetti, R., Bluestein, H.G., Peter, J.B., and Alexander, E.L. (1993) Neuropsychiatric disease in Sjögren's syndrome: anti-ribosomal P and anti-neuronal antibodies. The American journal of medicine 95, 153-160. DOI: https://doi.org/10.1016/0002-9343(93)90255-N

Mandl, T., Hammar, O., Theander, E., Wollmer, P., and Ohlsson, B. (2010) Autonomic nervous dysfunction development in patients with primary Sjögren’s syndrome: a follow-up study. Rheumatology (Oxford) 49, 1101-1106. DOI: https://doi.org/10.1093/rheumatology/keq042

Hatron, P.Y., Tillie-Leblond, I., Launay, D., Hachulla, E., Fauchais, A.L., and Wallaert, B. (2011) Pulmonary manifestations of Sjögren’s syndrome. Presse medicale (Paris, France : 1983) 40, e49-64. DOI: https://doi.org/10.1016/j.lpm.2010.11.002

Strimlan, C.V., Rosenow, E.C. III, Divertie, M.B., Harrison, E.G. Jr. (2003) Pulmonary manifestations of Sjögren’s syndrome. Chest 70,354-61. DOI: https://doi.org/10.1378/chest.70.3.354

Wright, S.A., Convery, R.P., Liggett, N. (2003) Pulmonary involvement in Sjögren’s syndrome. Rheumatology 42,697-8. DOI: https://doi.org/10.1093/rheumatology/keg149

Marrie, R.A. (2007) Autoimmune disease and multiple sclerosis: methods, methods, methods. Lancet Neurol 6, 575–76. DOI: https://doi.org/10.1016/S1474-4422(07)70157-6

Downloads

Published

2014-04-02

How to Cite

Koch, T., Al-Hashimi, I., Koffman, B. M., Deshpande, A., & Khuder, S. A. (2014). Comorbidities associated with Sjögren’s syndrome: Results from the Nationwide Inpatient Sample. Translation: The University of Toledo Journal of Medical Sciences, 1(1), 4–7. https://doi.org/10.46570/utjms.vol1-2014-74

Issue

Section

Research Articles