Lund University, Faculty of Medicine, Department of Clinical Sciences-Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.
Skåne University Hospital, Clinical Epidemiology Unit, Remissgatan 4, SE-221 85, Lund, Sweden.
Clin Rheumatol. 2018 Mar;37(3):825-830. doi: 10.1007/s10067-018-3983-8. Epub 2018 Jan 22.
Hospitalization is an important component of rheumatoid arthritis (RA) and gout economic burden. This study aimed to assess temporal trends and regional disparities in RA and gout hospitalizations among people aged ≥ 20 years in Sweden during 1998-2015. Data on hospital admissions with a principal diagnosis of RA or gout were collected from the National Patient Register. Age-standardized hospitalization rates (ASHRs) were calculated by means of direct standardization. The absolute and relative regional disparities were assessed. The temporal trends in ASHR and proportion of RA and gout hospitalizations from all and musculoskeletal disorders hospitalizations were analyzed using joinpoint regression. Between 1998-2000 and 2013-2015, the ASHR for RA declined by 78.9% from 109.9 to 23.2 per 100,000 Swedish adults, while it almost doubled for gout (from 10.5 to 20.8 per 100,000 Swedish adults). While in 1998-2000, RA hospitalizations were 10.3 times more frequent than gout (0.54 vs 0.05% of all hospitalizations), this ratio declined to 1.1 in 2013-2015 (0.13 vs 0.11% of all hospitalizations). The joinpoint regression revealed that, on average, the ASHR for RA declined by 10.2% (95% CI: 9.3-11.1) per year whereas for gout, it rose by 4.3% (3.2-5.4) per year during 1998-2015. While the relative regional disparities were stable, the absolute regional disparity declined for RA and increased for gout over the study period. While substantial decline in RA hospitalization is encouraging, the substantial rise in gout hospitalization is of concern, reflecting potential increase in prevalence of gout and suboptimal management of the disease.
住院治疗是类风湿关节炎（RA）和痛风经济负担的重要组成部分。本研究旨在评估 1998-2015 年期间瑞典≥20 岁人群中 RA 和痛风住院治疗的时间趋势和地区差异。通过国家患者登记处收集主要诊断为 RA 或痛风的住院数据。通过直接标准化计算年龄标准化住院率（ASHR）。评估绝对和相对区域差异。使用 joinpoint 回归分析 ASHR 以及 RA 和痛风在所有和肌肉骨骼疾病住院患者中的比例的时间趋势。1998-2000 年至 2013-2015 年，瑞典成年人 RA 的 ASHR 从 109.9 下降到 23.2/10 万，下降了 78.9%，而痛风的 ASHR 几乎翻了一番（从 10.5 上升到 20.8/10 万）。1998-2000 年，RA 住院治疗的频率是痛风的 10.3 倍（所有住院治疗的 0.54%比 0.05%），而在 2013-2015 年，这一比例下降到 1.1（所有住院治疗的 0.13%比 0.11%）。joinpoint 回归显示，RA 的 ASHR 平均每年下降 10.2%（95%CI：9.3-11.1），而痛风每年上升 4.3%（3.2-5.4）。虽然相对区域差异保持稳定，但 RA 的绝对区域差异在研究期间下降，而痛风的绝对区域差异增加。RA 住院治疗的大量下降令人鼓舞，但痛风住院治疗的大量增加令人担忧，这反映了痛风患病率的潜在增加和疾病管理的不足。
