Demographic and clinical factors associated with in-hospital death among patients with systemic sclerosis.

Objective: To examine demographic and clinical predictors of in-hospital death of patients with systemic sclerosis (SSc) and determine to what extent apparent racial differences may be attributed to socioeconomic factors.

Methods: Data were obtained on all hospitalizations in South Carolina for patients who were ever hospitalized between 1996 and 2000 with a diagnosis of SSc. Multiple logistic regression was used to examine predictors of in-hospital death among whites, blacks, and other patients.

Results: Proportions of in-hospital deaths among blacks (23.0%) and others (27.7%) were higher than among whites (15.6%), a finding that remained after adjustment for other sociodemographic and clinical factors (black/white odds ratio: 1.70, 95% confidence interval: 1.01-2.86; other/white OR 2.06, 95% CI 1.04-4.09). Other factors associated with in-hospital death included transfer status, emergency admission, length of stay, number of hospitalizations during the time period, and presence of congestive heart failure (OR 1.79; 95% CI 1.06-3.03) or hypertension (OR 0.41; 95% CI 0.23-0.71).

Conclusion: Black and other non-white patients with SSc appear to experience an elevated risk of death during their hospital stays. Further research is necessary to understand the reasons for these disparities.