دورية أكاديمية
Epidemiology and risk factors associated with avascular necrosis in patients with autoimmune diseases: a nationwide study
العنوان: | Epidemiology and risk factors associated with avascular necrosis in patients with autoimmune diseases: a nationwide study |
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المؤلفون: | Hsin-Lin Tsai, Jei-Wen Chang, Jen-Her Lu, Chin-Su Liu |
المصدر: | The Korean Journal of Internal Medicine, Vol 37, Iss 4, Pp 864-876 (2022) |
بيانات النشر: | The Korean Association of Internal Medicine, 2022. |
سنة النشر: | 2022 |
المجموعة: | LCC:Medicine |
مصطلحات موضوعية: | osteonecrosis, autoimmune disease, prednisolone, systemic lupus erythematosus, Medicine |
الوصف: | Background/Aims Avascular necrosis (AVN) is a clinical condition characterized by the death of bone components due to interruption in the blood supply. This study aimed to investigate the epidemiology and determine the risk factors for AVN in patients with autoimmune diseases. Methods We conducted a population-based retrospective cohort analysis using claims data from the Taiwan National Health Insurance Research Database. A total of 49,636 patients with autoimmune diseases between January 1, 2005 and December 31, 2013 were included. Cox regression analysis was used to identify associated risk factors for the development of AVN. Results A total of 490/49,636 patients (1.0%) developed symptomatic AVN. The systemic lupus erythematosus patients had a higher risk of AVN compared to other autoimmune diseases. AVN was positively correlated with male sex (p < 0.001), alcoholism (p < 0.001), mean daily prednisolone dosage 7.51 to 30 mg (p < 0.001) and > 30 mg (p < 0.001), and total cumulative prednisolone dose 0 g to 5 g (p = 0.002). However, AVN was inversely correlated with cumulative duration of hydroxychloroquine exposure > 0.6 years (p < 0.001). Conclusions Male sex, systemic lupus erythematosus, alcoholism, mean daily corticosteroid > 7.5 mg and a total cumulative dose of corticosteroid 0 to 5 g were independently associated with the development of AVN in autoimmune patients. While hydroxychloroquine use > 0.6 years conferred significant protection against the development of AVN. Clinicians should regularly assess patients with risk factors to enable the early diagnosis of AVN. |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 1226-3303 2005-6648 |
Relation: | http://kjim.org/upload/pdf/kjim-2020-098.pdf; https://doaj.org/toc/1226-3303; https://doaj.org/toc/2005-6648 |
DOI: | 10.3904/kjim.2020.098 |
URL الوصول: | https://doaj.org/article/3907871f04e44a7cb0cff66019eb783a |
رقم الأكسشن: | edsdoj.3907871f04e44a7cb0cff66019eb783a |
قاعدة البيانات: | Directory of Open Access Journals |
تدمد: | 12263303 20056648 |
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DOI: | 10.3904/kjim.2020.098 |