Parodi M, Bensi L, Maio T, Mela G S, Cimmino M A
Clinica Reumatologica, Dipartimento di Medicina Interna e Specialità Mediche (DI.M.I.), Università degli Studi di Genova.
Reumatismo. 2005 Jul-Sep;57(3):154-60. doi: 10.4081/reumatismo.2005.154.
Arthritis is often associated with comorbidities. For many of them, such as hypertension, cardiovascular disease, chronic pulmonary disease, and upper gastrointestinal disease, arthritis and its treatment may also represent a risk factor. This study is concerned with an evaluation of the frequency of comorbidities in a cohort of patients with rheumatoid arthritis (RA).
The discharge diagnoses of patients with RA during the period 1 January 1997 to 31 December 2000 were retrieved from the database of the Department of Internal Medicine of the University of Genova, Italy. The diagnosis of RA was made if the patient's discharge record contained the code 714 of the International Classification of Diseases, IX revision, as first 3 numbers. The other diagnoses were also recorded along with demographic data, type and duration of hospital stay, and performed procedures.
During the study period, 427 patients with RA were admitted to the hospital for a total number of 761 admissions, which represented 2.2% of total admissions. Ninety-one (21.3%) patients did not have comorbidities, whereas 336 (78.6%) had one or more comorbidities. The most frequently observed comorbidities were cardiovascular diseases (34.6%), including hypertension (14.5%) and angina (3.5%), followed by gastrointestinal (24.5%), genito-urinary (18.7%) and respiratory (17%) diseases. There was a male predominance (p=0.004) within patients with comorbidities, who were significantly older (64.2+/-3.2 years vs. 57.2+/-4.2 years; p<0.001) and required longer periods of hospital stay (22.7 days vs. 12.5 days; p<0.001).
Comorbidities are present in nearly 80% of RA inpatients. Comorbidity is a good predictor of health outcome, health services utilization, and medical costs. Because RA comorbidity can act as confounder, it should be considered in epidemiologic studies and clinical trials.
关节炎常与合并症相关。对于其中许多合并症，如高血压、心血管疾病、慢性肺部疾病和上消化道疾病，关节炎及其治疗也可能是一个危险因素。本研究旨在评估类风湿关节炎（RA）患者队列中合并症的发生频率。
从意大利热那亚大学内科数据库中检索1997年1月1日至2000年12月31日期间RA患者的出院诊断。如果患者的出院记录包含国际疾病分类第九版的代码714作为前三位数字，则诊断为RA。其他诊断以及人口统计学数据、住院类型和时长以及所进行的手术也被记录下来。
在研究期间，427例RA患者共住院761次，占总住院次数的2.2%。91例（21.3%）患者没有合并症，而336例（78.6%）患者有1种或多种合并症。最常观察到的合并症是心血管疾病（34.6%），包括高血压（14.5%）和心绞痛（3.5%），其次是胃肠道疾病（24.5%）、泌尿生殖系统疾病（18.7%）和呼吸系统疾病（17%）。合并症患者中男性占优势（p = 0.004），他们年龄显著更大（64.2±3.2岁对57.2±4.2岁；p<0.001），且住院时间更长（22.7天对12.
