Number of Attending Physicians and Accumulated Organ Damage in Patients with Systemic Lupus Erythematosus: LUNA Registry Cross-Sectional Study

Ryo Yanai, Nobuyuki Yajima, Nao Oguro, Yasuhiro Shimojima, Shigeru Ohno, Hiroshi Kajiyama, Kunihiro Ichinose, Shuzo Sato, Michio Fujiwara, Yoshia Miyawaki, Ryusuke Yoshimi, Takashi Kida, Yusuke Matsuo, Keisuke Nishimura, Ken ei Sada

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Introduction: Patients with systemic lupus erythematosus (SLE) frequently change attending physicians. The number of changes in attending physicians is related to the accumulated organ damage in patients with diabetes mellitus and inflammatory bowel disease, although similar results are not known for patients with SLE. This study investigated whether the number of attending physicians after the onset of SLE is associated with organ damage. Methods: Patients with SLE were enrolled in a multicenter registry of 14 institutions (the Lupus Registry of Nationwide Institutions). Patients with a disease duration of 6 months to 10 years were included. Exposure was defined as the number of attending physicians. The primary outcome was the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SDI). The secondary outcomes were corticosteroid- and non-corticosteroid-related damage. Multiple logistic regression analysis was used to estimate the association between the number of attending physicians and SDI, adjusting for potential confounders, including age, sex, disease duration, number of hospitalizations due to SLE, disease activity at diagnosis, and emotional health. Results: Of the 702 patients, 86.5% were women (median age 46 years, interquartile range 35–58). The disease duration was 7.3 years (4.3–11.3), the number of hospitalizations due to SLE was 1 (1–3), the number of attending physicians was 3 (2–4), and SDI was 0 points (0–1). The number of attending physicians was significantly associated with SDI [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.03–1.26]. In the secondary outcome, the number of attending physicians was significantly associated with corticosteroid-related damage (OR 1.22, 95% CI 1.09–1.38). The number of attending physicians was not significantly associated with non-corticosteroid-related damage (OR 1.08, 95% CI 0.99–1.19). Conclusions: This study showed that SDI could increase as the number of attending physicians increases. The impact of changing attending physicians warrants greater attention for SLE and other diseases.

Original languageEnglish
Pages (from-to)421-431
Number of pages11
JournalRheumatology and Therapy
Volume10
Issue number2
DOIs
Publication statusPublished - Apr 2023

Keywords

  • Attending physicians
  • Organ damage
  • Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy

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