Birmingham VA Medical Center, Birmingham, and School of Public Health, University of Alabama at Birmingham, and Mayo Clinic College of Medicine, Rochester, Minnesota.
School of Public Health, University of Alabama at Birmingham.
Arthritis Care Res (Hoboken). 2018 Feb;70(2):320-326. doi: 10.1002/acr.23270. Epub 2018 Jan 18.
To assess the health care utilization and emergency department (ED) charges for septic arthritis.
We performed a retrospective cohort study of ED visits with septic arthritis as the primary diagnosis using the US Nationwide Emergency Department Sample data from 2009-2012. We examined ED charges, hospitalization, and associated time trends. Multivariable models were adjusted for demographics (age, sex, insurance status, residence, and household income), comorbidity, and hospital characteristics to assess factors associated with ED charges and hospitalization.
Septic arthritis was responsible for 16,382 ED visits in 2012 in the US, which constituted 0.01% of all ED visits. The number of ED visits was stable from 2009-2012. Total ED charges were $34.6, $30.6, and $36.9 million in 2009, 2010, and 2012, respectively, and mean ED charges were $2,149, $1,866, and $2,257, respectively. The majority of the patients with an ED visit for septic arthritis were hospitalized: 82%, 83%, and 84% in 2009, 2010, and 2012, respectively. Metropolitan residence and western US location were associated with higher ED charges, and the highest income quartile, renal failure, or osteoarthritis were associated with lower ED charges. Female sex, metropolitan residence, metropolitan teaching hospital status, and medical comorbidity (diabetes mellitus, hyperlipidemia, hypertension, chronic obstructive pulmonary disease, coronary heart disease, gout, osteoarthritis, renal failure, and heart failure) were associated with a higher risk of hospitalization.
Comorbidities were associated with a higher risk of hospitalization after an ED visit for septic arthritis, but not higher ED charges. No time trends in ED visit incidence, ED charges, or hospitalization rate for septic arthritis from 2009-2012 were noted.
评估脓毒性关节炎的医疗保健利用和急诊部（ED）费用。
我们使用美国 2009-2012 年全国急诊部样本数据，对以脓毒性关节炎为主要诊断的 ED 就诊进行了回顾性队列研究。我们检查了 ED 费用、住院治疗和相关的时间趋势。多变量模型调整了人口统计学因素（年龄、性别、保险状况、居住地和家庭收入）、合并症和医院特征，以评估与 ED 费用和住院治疗相关的因素。
2012 年，美国有 16382 例 ED 就诊是由脓毒性关节炎引起的，占所有 ED 就诊的 0.01%。2009-2012 年，ED 就诊数量保持稳定。2009 年、2010 年和 2012 年的 ED 总费用分别为 3460 万美元、3060 万美元和 3690 万美元，平均 ED 费用分别为 2149 美元、1866 美元和 2257 美元。大多数因脓毒性关节炎而接受 ED 就诊的患者都住院了：2009 年、2010 年和 2012 年分别为 82%、83%和 84%。大都市居住和美国西部地区与更高的 ED 费用相关，而最高收入四分位数、肾衰竭或骨关节炎与更低的 ED 费用相关。女性、大都市居住、大都市教学医院状况以及医疗合并症（糖尿病、高脂血症、高血压、慢性阻塞性肺疾病、冠心病、痛风、骨关节炎、肾衰竭和心力衰竭）与 ED 就诊后住院治疗的风险增加相关。
合并症与 ED 就诊后脓毒性关节炎住院治疗的风险增加相关，但与 ED 费用无关。2009-2012 年，脓毒性关节炎的 ED 就诊发生率、ED 费用或住院率没有时间趋势。
