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Respir Med Res . Impact of systemic sclerosis on outcomes of patients hospitalized for influenza: Evidence from the US nationwide inpatient sample

tetano

Editor, Senior Moderator
Respir Med Res


. 2025 Nov 28:89:101232.
doi: 10.1016/j.resmer.2025.101232. Online ahead of print. Impact of systemic sclerosis on outcomes of patients hospitalized for influenza: Evidence from the US nationwide inpatient sample

Ang-Jun Liu[SUP] 1 [/SUP], Hen-Hong Chang[SUP] 2 [/SUP], Hsueh-Ting Chu[SUP] 3 [/SUP], Tai-Hua Yang[SUP] 4 [/SUP], Yu-Pei Chen[SUP] 5 [/SUP]



Affiliations
Abstract

Background: Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by fibrosis and immune dysregulation, often involving pulmonary and cardiovascular systems. Limited data exist regarding its impact on outcomes among patients hospitalized with influenza.
Methods: Using the US Nationwide Inpatient Sample (2016-2020), we identified adults hospitalized with a principal diagnosis of influenza using ICD-10 codes. Patients were categorized into SSc and non-SSc groups. Propensity score matching (1:4) was applied to balance baseline characteristics. Logistic and linear regression analyses estimated adjusted odds ratios (aORs) or coefficients with 95% confidence intervals (CIs) for in-hospital mortality, complications, length of stay (LOS), and adverse discharge outcomes.
Results: After matching, 1,265 patients (253 with SSc, 1,012 without SSc) were included, representing 6,248 hospitalizations nationwide after weighting. Compared with non-SSc patients, those with SSc had significantly higher risks of secondary bacterial or fungal infections (aOR = 1.42; 95% CI: 1.05-1.92; p = 0.025) and bronchiectasis (aOR = 3.91; 95% CI: 1.77-8.65; p < 0.001). Among patients aged ≥60 years, SSc was associated with increased risks of bronchiectasis (aOR = 4.67; 95% CI: 2.13-10.24) and respiratory failure requiring mechanical ventilation (aOR = 1.47; 95% CI: 1.06-2.02). Smokers with SSc had a higher risk of shock, while non-smokers with SSc remained at elevated risk for secondary infections, bronchiectasis, and respiratory failure.
Conclusions: SSc was associated with excess risks of severe in-hospital complications among influenza patients, particularly in older adults and smokers, underscoring the need for targeted prevention and early intervention strategies.

Keywords: Hospitalization; Influenza; Nationwide inpatient sample (NIS); Outcomes; Systemic sclerosis (SSc).

 
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