Title : Risk factors for development of severe gastrointestinal dysmotility in patients with systemic sclerosis
Abstract:
Background
Systemic Sclerosis (SSc) is an autoimmune condition of unknown etiology. We aim to investigate incidence, characteristics, and risk factors for gastrointestinal (GI) dysmotility in patients diagnosed with SSc using Cerner HealthFacts, a national longitudinal database representing approximately 69 million patients.
Methods All patients over 18 years of age with SSc were included in our analysis. Incidence of GI dysmotility was identified using ICD coding. Patient characteristics were evaluated as potential risk factors for development of GI dysmotility using multivariable regression built using all variables with p<0.1 on univariable analysis.
Results Overall, 0.4% (58/13,930) of patients with SSc developed GI dysmotility. Mean age was 57.23±15.22 years and 16% (2,228/13,930) were male and 86.1% (11,502/13,930) were female. In terms of race, 70.15% (9,772/13,930) were white and 14.82% (2,064/13,930) were African American. 92.51% (12,886/13,930) received care at an acute care facility and 81.51% (11,354/13,930) received care at an urban facility. The variables which conferred the highest odds of developing GI dysmotility included presence of hepatic comorbidities (OR 2.35), digestive comorbidities (OR 6.75), muscular dystrophy (OR 569.2), and Raynaud (OR 1.98). In our univariable analysis and multivariable regression model with 95% confidence intervals; 4 variables were predictive for GI dysmotility, and no variables were protective against GI dysmotility.
Conclusions In this longitudinal national database study of patient with diagnosed SSc - hepatic, digestive comorbidities, muscular dystrophy, and Raynaud were noted to be associated with high risk of developing GI dysmotility. Careful evaluation and follow up is advised for SSc patients.
