{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:20:40Z","timestamp":1792801240413,"version":"4.5.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"research funds from the Division of Rheumatology at the University of Alabama at Birmingham","award":["No number"],"award-info":[{"award-number":["No number"]}],"id":[{"id":"https:\/\/ror.org\/008s83205","id-type":"ROR","asserted-by":"crossref"}]},{"name":"the resources and use of facilities at the Birmingham VA Medical Center, Birmingham, Alabama, USA","award":["No number"],"award-info":[{"award-number":["No number"]}],"id":[{"id":"https:\/\/ror.org\/0242qs713","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study incidence, time trends, and outcomes of serious infections in systemic sclerosis (SSc).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the 1998\u20132016\u2009US National Inpatient Sample data. We examined the epidemiology, time trends, and outcomes of five serious infections (opportunistic infections (OI), skin and soft tissue infections (SSTI), urinary tract infection (UTI), pneumonia, and sepsis\/bacteremia) in hospitalized people with SSc. We performed multivariable-adjusted logistic regression analyses to analyze independent association of factors with healthcare utilization (hospital charges, length of hospital stay, discharge to non-home setting) and in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 49,904,955 hospitalizations with serious infections in people without SSc and 61,615 in those with SSc. During 1998\u20132016, the most common serious infections in SSc were pneumonia (45%), sepsis (32%), SSTI (19%), UTI (3%), and OI (3%). In 2013\u20132014, sepsis surpassed pneumonia as the most common serious infection; by 2015\u20132016, sepsis was 1.8 times more common than pneumonia. Over the study period, hospital charges increased, while length of hospital stay and in-hospital mortality decreased, overall and for each serious infection. Multivariable-adjusted analyses showed that sepsis, age\u2009\u2265\u200980\u2009years, and Deyo-Charlson score\u2009\u2265\u20092 were associated with significantly higher odds of healthcare utilization and in-hospital mortality, and Medicare or Medicaid insurance payer, Northeast location, urban teaching or non-teaching hospital, and medium or large hospital bed size with significantly higher odds of healthcare utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Outcomes in people with SSc hospitalized with serious infections have improved over time, except higher hospital charges. Identification of factors associated with higher healthcare utilization and in-hospital mortality allows for developing interventions to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13075-020-02216-w","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T07:02:59Z","timestamp":1593414179000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Serious infections in people with systemic sclerosis: a national US study"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3485-0006","authenticated-orcid":false,"given":"Jasvinder A.","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Cleveland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,29]]},"reference":[{"issue":"3","key":"2216_CR1","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1002\/acr.22121","volume":"66","author":"L Chung","year":"2014","unstructured":"Chung L, Domsic RT, Lingala B, Alkassab F, Bolster M, Csuka ME, Derk C, Fischer A, Frech T, Furst DE, et al. Survival and predictors of mortality in systemic sclerosis-associated pulmonary arterial hypertension: outcomes from the pulmonary hypertension assessment and recognition of outcomes in scleroderma registry. Arthritis Care Res (Hoboken). 2014;66(3):489\u201395.","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"9","key":"2216_CR2","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1093\/rheumatology\/key150","volume":"57","author":"D Ram Poudel","year":"2018","unstructured":"Ram Poudel D, George M, Dhital R, Karmacharya P, Sandorfi N, Derk CT. Mortality, length of stay and cost of hospitalization among patients with systemic sclerosis: results from the National Inpatient Sample. 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The IRB waived the need for an informed consent for this database study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No individual person\u2019s data were presented in any form in this study, and therefore, no consent to publish is required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"There are no financial conflicts related directly to this study. JAS has received consultant fees from Crealta\/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Clinical Care options, Clearview healthcare partners, Putnam associates, Spherix, Practice Point communications, the National Institutes of Health, and the American College of Rheumatology. JAS owns stock options in Amarin pharmaceuticals and Viking therapeutics. JAS is on the speaker\u2019s bureau of Simply Speaking. JAS is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies. JAS is a member of the Veterans Affairs Rheumatology Field Advisory Committee. JAS is the editor and the Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. JAS served as a member of the American College of Rheumatology\u2019s (ACR) Annual Meeting Planning Committee (AMPC) and Quality of Care Committees; the Chair of the ACR Meet-the-Professor, Workshop and Study Group Subcommittee; and the co-chair of the ACR Criteria and Response Criteria subcommittee. JDC has no conflicts of interest. There are no non-financial competing interests for either author.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"163"}}