Infection versus cardiovascular disease as leading causes of hospitalisations and associated mortality in vasculitis in the U.S.: a national study.

OBJECTIVES

To assess the top 5 causes of non-vasculitis hospitalisations in people with vasculitis over time.

METHODS

In a national U.S. sample of people with vasculitis hospitalised for reasons other than vasculitis, the rank (and percent) of top 5 causes of hospitalisations and in-hospital mortality were compared in 1998-99 versus 2013-2014.

RESULTS

The top 5 ranked disease categories responsible for non-vasculitis hospitalisations in people with vasculitis in 1998-99 versus 2013-14 were as follows, respectively: (#1) circulatory system disease versus the same; (#2) heart disease versus infections/parasitic diseases; (#3) digestive system disease versus bacterial infection; (#4) respiratory disease versus septicaemia; and (#5) musculoskeletal disease versus unspecified septicaemia. The respective top 5 CCS category ranks for in-hospital mortality in people with vasculitis in 1998-1999 versus 2013-2014 were: (#1) respiratory disease versus infections/parasitic diseases; (#2) circulatory system disease versus bacterial infection; (#3) heart disease versus septicaemia; (#4) respiratory infection versus unspecified septicaemia; and (#5) pneumonia versus circulatory system disease.

CONCLUSIONS

Infections replaced cardio-pulmonary disease among the top 5 causes for non-primary vasculitis hospitalisations and associated in-hospital mortality in people with vasculitis over time. Studies should examine modifiable factors associated with infection in vasculitis and design interventions to reduce this burden.