Strahl A, Schneider O, Frankenhauser-Mannuß J, Knapstein S, Hermann C, Lembeck B, Lorenz H-M, Rüther W, Flechtenmacher J
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Orthopädie, Martinistr. 52, 20246, Hamburg, Deutschland.
AOK Baden-Württemberg, Presselstr. 19, 70191, Stuttgart, Deutschland.
Z Rheumatol. 2018 Mar;77(2):113-126. doi: 10.1007/s00393-017-0381-6.
Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population.
Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services.
In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA. The study was based on out- and inpatient diagnoses from 2013.
The RA prevalence was 0.64% (n = 26,919), the incidence was 0.04%. Patients with RA have significant more comorbidities in almost all diagnosis groups, especially in musculoskeletal and cardiovascular diseases, compared to a control group (n = 181,209). 22.8% of RA patients had not contacted an internist rheumatologist, orthopedist or orthopedic surgeon. Biological disease-modifying anti-rheumatic drugs (DMARDs) were almost exclusively prescribed by internist rheumatologists, while conventional DMARDs were equally prescribed by general practitioners and rheumatologists. Of the RA patients 32.6% were hospitalized at least once a year and were nearly twice as frequently inpatient as the control group.
RA patients need more in- and outpatient healthcare services and suffer significantly more often from comorbidities. The general practitioner is the most frequently visited physician. Other consulted physicians are rheumatologists, ophthalmologists, orthopedists/orthopedic surgeons and internists not specialized in rheumatology. The study highlights the need to create consensus treatment algorithms and maintain a close interdisciplinary and intersectoral cooperation and communication.
与普通人群相比，类风湿关节炎（RA）的合并症数量更多。
研究目的是收集有关RA的患病率、发病率和合并症以及门诊和住院护理服务利用情况的流行病学数据。
在一项年龄和性别调整的病例对照研究中，对德国巴登-符腾堡州AOK保险公司承保的340万患者的就诊情况、RA的患病率、发病率和合并症进行了分析。该研究基于2013年的门诊和住院诊断。
RA患病率为0.64%（n = 26,919），发病率为0.04%。与对照组（n = 181,209）相比，RA患者在几乎所有诊断组中都有更多的合并症，尤其是在肌肉骨骼和心血管疾病方面。22.8%的RA患者未联系过内科风湿病学家、骨科医生或整形外科医生。生物性改善病情抗风湿药（DMARDs）几乎完全由内科风湿病学家开具，而传统DMARDs由全科医生和风湿病学家开具的比例相同。32.6%的RA患者每年至少住院一次，住院频率几乎是对照组的两倍。
RA患者需要更多的门诊和住院医疗服务，并且合并症的发生率明显更高。全科医生是就诊最频繁的医生。其他咨询过的医生包括风湿病学家、眼科医生、骨科医生/整形外科医生和非风湿病专科的内科医生。该研究强调需要制定共识治疗算法，并保持密切的跨学科和跨部门合作与沟通。
