Tags

Type your tag names separated by a space and hit enter

Risk of preventable hospitalization before and after diagnosis among rheumatoid arthritis patients compared to non-rheumatoid arthritis controls.

Abstract

OBJECTIVE

The purpose of the study is to investigate the risk of preventable hospitalization among patients with rheumatoid arthritis (RA).

METHODS

We identified 11,852 incident RA patients and 59,260 age-, sex-, and index year-matched controls from the Taiwan National Health Insurance Database. Index date was the RA diagnosis date for cases, which was assigned to their matched controls. The odds ratios (OR) of preventable hospitalizations between RA patients and controls were estimated using a mixed effect model adjusted for age, sex, patient characteristics, Elixhauser comorbidity index, medical utilization and regional medical resources.

RESULTS

The overall annualized incidence of preventable hospitalization in RA patients and controls was 38.7 vs. 20.9 events per 1,000 person-years (adjusted OR, 1.61; 95% confidence interval [CI], 1.51-1.71). The adjusted OR of preventable hospitalization in RA patients compared to matched controls was 1.17 (1.00-1.37) one year prior to RA diagnosis and remained elevated after RA diagnosis. Adjusted ORs (95% CI) for specific preventable hospitalization categories were 1.93 (1.58-2.36) for chronic obstructive pulmonary disease, 1.64 (1.21-2.21) for asthma, 1.95 (1.78-2.13) for bacterial pneumonia, and 1.59 (1.44-1.75) for urinary tract infection. When assessing the trend of individual preventable hospitalizations before and after diagnosis, bacterial pneumonia and urinary tract infection hospitalizations had a significantly higher OR in RA patients one year before diagnosis and five years afterward (adjusted OR ranges 2.75 to 4.48 and 1.83 to 3.07 respectively, all P-values<0.05) CONCLUSION: RA is independently associated with a higher risk of preventable hospitalization specifically for chronic lung diseases and infections.

Authors+Show Affiliations

Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK; Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States.Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States.Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States. Electronic address: kecchung@med.umich.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31811929

Citation

Kuo, Chang-Fu, et al. "Risk of Preventable Hospitalization Before and After Diagnosis Among Rheumatoid Arthritis Patients Compared to Non-rheumatoid Arthritis Controls." Joint, Bone, Spine : Revue Du Rhumatisme, 2019.
Kuo CF, Burns PB, Chen JS, et al. Risk of preventable hospitalization before and after diagnosis among rheumatoid arthritis patients compared to non-rheumatoid arthritis controls. Joint Bone Spine. 2019.
Kuo, C. F., Burns, P. B., Chen, J. S., Wang, L., & Chung, K. C. (2019). Risk of preventable hospitalization before and after diagnosis among rheumatoid arthritis patients compared to non-rheumatoid arthritis controls. Joint, Bone, Spine : Revue Du Rhumatisme, doi:10.1016/j.jbspin.2019.11.005.
Kuo CF, et al. Risk of Preventable Hospitalization Before and After Diagnosis Among Rheumatoid Arthritis Patients Compared to Non-rheumatoid Arthritis Controls. Joint Bone Spine. 2019 Dec 4; PubMed PMID: 31811929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of preventable hospitalization before and after diagnosis among rheumatoid arthritis patients compared to non-rheumatoid arthritis controls. AU - Kuo,Chang-Fu, AU - Burns,Patricia B, AU - Chen,Jung-Sheng, AU - Wang,Lu, AU - Chung,Kevin C, Y1 - 2019/12/04/ PY - 2019/09/04/received PY - 2019/11/20/accepted PY - 2019/12/8/pubmed PY - 2019/12/8/medline PY - 2019/12/8/entrez KW - Biologics KW - Preventable hospitalization KW - Rheumatoid arthritis JF - Joint, bone, spine : revue du rhumatisme JO - Joint Bone Spine N2 - OBJECTIVE: The purpose of the study is to investigate the risk of preventable hospitalization among patients with rheumatoid arthritis (RA). METHODS: We identified 11,852 incident RA patients and 59,260 age-, sex-, and index year-matched controls from the Taiwan National Health Insurance Database. Index date was the RA diagnosis date for cases, which was assigned to their matched controls. The odds ratios (OR) of preventable hospitalizations between RA patients and controls were estimated using a mixed effect model adjusted for age, sex, patient characteristics, Elixhauser comorbidity index, medical utilization and regional medical resources. RESULTS: The overall annualized incidence of preventable hospitalization in RA patients and controls was 38.7 vs. 20.9 events per 1,000 person-years (adjusted OR, 1.61; 95% confidence interval [CI], 1.51-1.71). The adjusted OR of preventable hospitalization in RA patients compared to matched controls was 1.17 (1.00-1.37) one year prior to RA diagnosis and remained elevated after RA diagnosis. Adjusted ORs (95% CI) for specific preventable hospitalization categories were 1.93 (1.58-2.36) for chronic obstructive pulmonary disease, 1.64 (1.21-2.21) for asthma, 1.95 (1.78-2.13) for bacterial pneumonia, and 1.59 (1.44-1.75) for urinary tract infection. When assessing the trend of individual preventable hospitalizations before and after diagnosis, bacterial pneumonia and urinary tract infection hospitalizations had a significantly higher OR in RA patients one year before diagnosis and five years afterward (adjusted OR ranges 2.75 to 4.48 and 1.83 to 3.07 respectively, all P-values<0.05) CONCLUSION: RA is independently associated with a higher risk of preventable hospitalization specifically for chronic lung diseases and infections. SN - 1778-7254 UR - https://www.unboundmedicine.com/medline/citation/31811929/Risk_of_preventable_hospitalization_before_and_after_diagnosis_among_rheumatoid_arthritis_patients_compared_to_non-rheumatoid_arthritis_controls L2 - https://linkinghub.elsevier.com/retrieve/pii/S1297-319X(19)30171-X DB - PRIME DP - Unbound Medicine ER -