Iyer Priyanka, Gao Yubo, Field Elizabeth H, Curtis Jeffrey R, Lynch Charles F, Vaughan-Sarrazin Mary, Singh Namrata
University of California at Irvine Medical Center.
Iowa City Veteran's Affairs Medical Center, and University of Iowa, Iowa City, Iowa.
ACR Open Rheumatol. 2020 Dec;2(12):715-724. doi: 10.1002/acr2.11200. Epub 2020 Nov 20.
To evaluate national trends in hospitalizations and in-hospital mortality in rheumatoid arthritis (RA).
National Inpatient Sample from 2000-2014 and United States Census data were used to study temporal trends in adult RA hospitalizations, reasons for hospitalizations, and in-hospital mortality.
The data represented 183 983 hospitalizations with a primary diagnosis of RA. The annual rates of hospitalization for the primary diagnosis of RA decreased from 76.54 admissions per 1 million in 2000 to 29.96 per 1 million in 2014 (P trend < 0.0001). The hospital mortality rate declined from 0.70% to 0.41% (P trend < 0.0001) in this group. With a primary or nonprimary diagnosis of RA, the mortality rate ranged between 1.95 and 2.87 (P trend 0.08). For a nonprimary diagnosis of RA, we noted that the proportion of hospitalizations with a diagnosis of myocardial infarction (6.4% in 2000 to 4.6% in 2014; P < 0.001) significantly decreased, but the absolute number of hospitalizations significantly increased. In contrast, the proportion and the absolute number of hospitalizations with any diagnosis of sepsis, congestive heart failure, lung disease, and urinary tract infection increased significantly. We also noted a significant increase in the actual rate and proportions for hospitalizations for hip and knee arthroplasty. Among in-hospital deaths when RA was a nonprimary diagnosis, the most common primary diagnosis was pneumonia (12.5 %) in 2000, whereas sepsis accounted for the most deaths in 2014 (31.4%).
We observed that hospitalization rates and in-hospital mortality rates in patients with RA have changed significantly over the past 15 years.
评估类风湿关节炎（RA）患者住院率及住院死亡率的全国趋势。
利用2000年至2014年的全国住院患者样本和美国人口普查数据，研究成年RA患者的住院时间趋势、住院原因及住院死亡率。
数据涵盖183983例以RA为主要诊断的住院病例。RA主要诊断的年住院率从2000年的每100万人76.54例降至2014年的每100万人29.96例（P趋势<0.0001）。该组患者的住院死亡率从0.70%降至0.41%（P趋势<0.0001）。对于RA的主要或非主要诊断，死亡率在1.95至2.87之间（P趋势0.08）。对于RA的非主要诊断，我们注意到诊断为心肌梗死的住院比例显著下降（从2000年的6.4%降至2014年的4.6%；P<0.001），但住院绝对数显著增加。相比之下，任何诊断为败血症、充血性心力衰竭、肺部疾病和尿路感染的住院比例和绝对数均显著增加。我们还注意到髋关节和膝关节置换术的实际住院率和比例显著增加。在RA为非主要诊断的住院死亡病例中，2000年最常见的主要诊断是肺炎（12.5%），而2014年败血症导致的死亡最多（31.4%）。
我们观察到，在过去15年中，RA患者的住院率和住院死亡率发生了显著变化。
