Population-based analysis of hospitalizations for patients with systemic sclerosis in a West-European region over the period 2001-2012.

The aim of this study was to evaluate systemic sclerosis (SSc) hospitalizations through a retrospective population-based study analyzing administrative data during 2001-2012 in Sardinia, an Italian region with universal Health System coverage. Data on hospital discharge records with ICD-9-CM code for SSc (710.1) were obtained from the Department of Health and Hygiene. Two-tailed Cochran-Armitage test for trend was applied to analyze the annual trend for primary and non-primary discharge diagnoses. SSc prevalence was also estimated. This study included 4981 hospitalizations in 736 patients (84.8 % women). Hospitalizations with SSc as primary diagnosis were 3631 (72.9 %). Their annual number significantly increased during study period, from 143 in 2001 to 390 in 2012. Annual trend analysis revealed statistically significant increase in number and percentage of interstitial lung disease (p < 0.0001), pulmonary arterial hypertension (p < 0.0024), osteoporotic fragility fractures (p < 0.0001), ulcers, and gangrene (p = 0.0037) as non-primary diagnoses associated with SSc. Although the number of admissions with SSc as non-primary diagnosis showed a slight reduction during the study period, the annual number and percentage of admissions with respiratory failure (p = 0.0016) and congestive heart failure (p < 0.0001) as primary diagnosis showed a significant upward trend. Admissions for intravenous infusion, mainly day-hospital, accounted for 19.1 % of all hospitalizations for SSc and showed a significant (p = 0.0002) upward trend in 2001-2012. The 2012 SSc prevalence in Sardinia was estimated to be 34.8 per 100,000 inhabitants. Hospital care utilization for SSc is changing over time, showing increased hospitalizations aimed at the early recognition and treatment for the major manifestations and complications of SSc.