To determine the frequency and clinical characteristics of systemic sclerosis-related digital ulcers, and associated direct health care costs, quality of life, and survival. Digital ulcers (DUs) were defined as an area with a visually discernible depth and a loss of continuity of epithelial coverage. DU severity was calculated based on the physician reported highest number of new DUs at clinical review (mild = 1–5 DUs, moderate 6–10 DUs, severe > 10 DUs). Healthcare use was captured through data linkage, wherein SSc clinical data captured prospectively in a dedicated clinical database were linked with health services databases to capture hospital admissions, emergency department (ED) presentations and ambulatory care (MBS) utilization and cost for the period 2008–2015. Healthcare cost determinants were estimated using logistic regression. Among 1085 SSc patients, 48.6% experienced a DU over a mean follow-up of 5.2 ± 2.5 years. Those who developed DUs were more likely to have diffuse disease subtype (34.9% vs 18.2%, p < 0.001), anti-Scl-70 antibody (18.9% vs 9.3%, p < 0.001), and a younger age at SSc onset (43.6 ± 13.9 vs 48.8 ± 14.0 years, p < 0.001) in addition to reduced health-related quality of life (HRQoL) measured by the SF-36 but without a significant impact on survival. SSc patients with a history of a DU utilized significantly more healthcare resources per annum than those without a DU, including hospitalizations, ED presentation, and ambulatory care services. Total healthcare services, excluding medications, were associated with an annual excess cost per DU patient of AUD$12,474 (8574-25,677), p < 0.001, driven by hospital admission and ED presentation costs. DUs place a large burden on the patient and healthcare system through reduced HRQoL and increased healthcare resource utilization and associated cost.

中文翻译：

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系统性硬化症中的数字溃疡：其流行病学，临床特征以及相关的临床和经济负担

确定与系统性硬化症相关的数字溃疡的频率和临床特征，以及相关的直接医疗保健费用，生活质量和生存率。数位溃疡（DU）定义为视觉上可辨别的深度且上皮覆盖范围失去连续性的区域。DU严重程度的计算是根据临床报告中医生报告的新DU的最高数量（轻度= 1–5 DU，中度6–10 DU，严重> 10 DU）。通过数据链接捕获了医疗保健用途，其中在专用临床数据库中前瞻性捕获的SSc临床数据与卫生服务数据库相链接，以捕获2008年期间的住院人数，急诊科（ED）演示和非卧床护理（MBS）利用率和成本。 2015年。使用Logistic回归估算医疗保健成本决定因素。在1085名SSc患者中，平均随访时间为5.2±2.5年，有48.6％的患者经历了DU。发生DUs的患者更有可能患有弥漫性疾病亚型（34.9％vs 18.2％，p <0.001），抗Scl-70抗体（18.9％vs 9.3％，p <0.001），并且在SSc发作时年龄较小（ 43.6±13.9岁vs 48.8±14.0岁，p <0.001），此外，SF-36测得的健康相关生活质量（HRQoL）降低，但对生存率没有显着影响。具有DU病史的SSc患者每年使用的医疗资源比没有DU的SSc患者要多得多，包括住院，急诊就诊和非卧床护理服务。总的医疗服务（不包括药物）与每位DU患者每年的超额费用为12,474澳元（8574-25,677），p <0.001，这是由入院费用和ED呈报费用驱动的。