Digital ulcers in systemic sclerosis: their epidemiology, clinical characteristics, and associated clinical and economic burden

Table 6 Determinants of above-median annual total healthcare cost and its components in SSc-DU in multivariable logistic regression

	OR (95%CI)	p value
Determinants of annual total healthcare cost
Female	1.21 (0.7–2.1)	0.48
Age at SSc onset*, years	1.03 (1.0–1.1)	< 0.001
Caucasian ethnicity	0.55 (0.2–1.6)	0.27
Diffuse subtype	0.71 (0.4–1.2)	0.19
ILD	1.38 (0.9–2.2)	0.16
PAH^#	1.78 (0.9–3.2)	0.05
PDE-5-inhibitor	1.0 (0.6–1.8)	0.99
Iloprost	1.77 (1.1–2.8)	0.02
Determinants of hospital cost
Female	1.20 (0.7–2.1)	0.49
Caucasian ethnicity	0.83 (0.3–2.3)	0.72
Age at SSc onset*, years	1.03 (1.0–1.1)	0.001
Diffuse subtype	0.97 (0.6–1.6)	0.91
PAH^#	1.32 (0.7–2.3)	0.35
ILD	1.27 (0.8–1.9)	0.29
Iloprost	1.59 (1.0–2.5)	0.04
PDE5 inhibitor	1.13 (0.6–1.9)	0.68
Determinants of ED cost
Female	1.29 (0.7–2.3)	0.39
Caucasian ethnicity	0.96 (0.3–2.8)	0.94
Age at SSc onset*, years	1.02 (0.9–1.0)	0.06
Diffuse subtype	0.79 (0.5–1.3)	0.37
PAH^#	2.89 (1.4–5.9)	0.004
ILD	1.29 (0.8–2.1)	0.33
Determinants of MBS cost
Female	1.79 (1.0–3.2)	0.05
Age at SSc onset*, years	1.02 (1.0–1.1)	0.001
Caucasian ethnicity	0.82 (0.3–2.5)	0.001
Diffuse subtype	0.68 (0.4–1.1)	0.10
PAH^#	2.41 (1.3–4.5)	0.001
DU severity**
Mild	Baseline
Moderate	1.05 (0.6–1.9)	0.88
Severe	0.71 (0.3–1.6)	0.39
CVA	3.35 (1.1–10.4)	0.04
Diabetes mellitus	1.51 (0.6–3.8)	0.39

Abbreviations: DU digital ulceration, PAH pulmonary arterial hypertension, ILD interstitial lung disease, CVA cerebrovascular accident, CCB calcium channel blockers, ERAs endothelial receptor antagonists, PDE5 phosphodiesterase-5 inhibitors
*SSc onset defined as the first symptom of SSc (Raynaud phenomenon or other) *disease duration defined as from first non-Raynaud’s disease manifestation
**DU severity was calculated based on the physician reported highest number of new DUs on examination at clinical review (mild 1–5 new DU, moderate 6–10, and severe > 10 new DU)
^#PAH diagnosed on right heart catheterization (RHC) according to international criteria [11]

ISSN: 1478-6362