Risk of bleeding events among patients with systemic sclerosis and the general population in the UK: a large population-based cohort study
- 102 Downloads
To compare the risk of different bleeding outcomes between patients with systemic sclerosis (SSc) and the general population free of SSc.
Using UK electronic primary care data (2000–2012), 1314 patients with SSc and a matched SSc-free comparison cohort (n = 19,992) were followed until December 2013 to identify bleeding, confirmed following manual review of patient records including free text comments. Incidence rates were calculated and Cox regression used to estimate adjusted hazard ratios (HRs; SSc cohort vs. matched general population cohort) adjusted for confounders.
One hundred and twenty-seven bleeding events occurred in the SSc cohort and 1762 in the general population cohort; incidence rates per 1000 person-years for the SSc cohort and general population cohort were 0.5 versus 0.3 for hemorrhagic stroke, 4.1 versus 3.3 for gastrointestinal bleeding, 2.5 versus 1.7 for pulmonary hemorrhage, 8.4 versus 7.5 for urogenital bleeding, and 15.5 versus 12.9 for any of the aforementioned bleedings. Adjusted HRs (95% confidence intervals) were 1.21 (1.00–1.46) for any bleeding, 1.51 (0.54–4.21) for hemorrhagic stroke, 1.50 (0.96–2.35) for pulmonary hemorrhage, 1.08 (0.75–1.54) for gastrointestinal bleeds, and 1.28 (1.00–1.64) for urogenital bleeds. HRs were more often higher in SSc patients with organ involvement than without organ involvement and in those with diffuse cutaneous SSc.
• The risk of experiencing a major bleed may be higher among patients with SSc than the general population.
• Further large and well-designed studies are needed to corroborate our findings.
Keywords (MeSH)Cohort studies Hemorrhage Scleroderma Systemic United Kingdom
The authors acknowledge and thank Susan Bromley, EpiMed Communications Ltd. (Oxford, UK) for editorial support funded by Bayer AG.
This study was funded by Bayer AG.
Compliance with ethical standards
Conflict of interest
AM is a full-time employee of Bayer Consumer Care AG, Basel, Switzerland. LAGR, AG-P, and MES work for CEIFE, which have received research funding from Bayer AG. LAGR has received honoraria for serving on advisory boards for Bayer AG. The authors declare no non-financial conflict of interests.
This study used anonymized primary care electronic health records. No clinical subjects were involved and therefore informed consent was not applicable.
- 9.Stuart-Buttle CD, Read JD, Sanderson HF, Sutton YM (1996) A language of health in action: Read codes, classifications and groupings. Proc AMIA Annu Fall Symp 1996:75–79Google Scholar
- 10.NHS Digital. Read codes. https://digital.nhs.uk/article/1104/Read-Codes. Accessed 26 November 2018
- 11.GEMSCRIPT.http://www.inps4.co.uk/my-vision/news/gemscript-%C3%82%C2%96-new-dmd-drug-dictionary-vision. Accessed 26 November 2018