Internal Medicine, Reading Hospital and Medical Center, West Reading, PA, USA.
Rheumatology, University of Pennsylvania, Philadelphia, PA, USA.
Clin Rheumatol. 2021 Dec;40(12):4927-4932. doi: 10.1007/s10067-021-05842-0. Epub 2021 Jul 5.
Ankylosing spondylitis (AS) patients are at increased risk of vertebral compression fractures (VCF). Our objective was to examine the yearly trend of VCF hospitalizations in AS patients as compared to rheumatoid arthritis (RA) and the general population. National Inpatient Sample (NIS) database (2000-2014) was used to identify adult (≥ 18 years) hospitalizations, based on validated ICD-9 diagnosis codes. The rate of VCF hospitalizations, as a primary diagnosis, was assessed in three mutually exclusive groups: AS, RA, and the general population. The prevalence of VCF hospitalization was highest in AS (2.70%), compared to 0.77% in RA and 0.35% in the general population. Over the 15-year period, VCF hospitalization in AS was noted to have an increasing trend (Annual Percent Change (APC) = 4.73, p < 0.05) in contrast to the stable trend in the general population (APC = 0.34, p = NS) and a declining trend in RA (APC -3.61, p < 0.05). VCF related to AS was also associated with a longer hospital stay as compared to the general population (8.1 days vs. 5.1 days, p < 0.05) and higher inpatient mortality (3.4% vs. 1.0%, p < 0.05). A higher rate of VCF hospitalization along with an increasing trend was noted in AS as compared to RA and compared to the general population. Better screening approaches and treatment strategies for AS patients with VCF risk are urgently needed to reduce hospitalizations and related complications. Key Points • An increasing trend of VCF hospitalization was noted in AS, in contrast to a declining trend in RA and a stable trend in the general population. • VCF in AS was associated with longer hospital stay and higher inpatient mortality than in RA and the general population.
强直性脊柱炎（AS）患者发生椎体压缩性骨折（VCF）的风险增加。我们的目的是比较 AS 患者与类风湿关节炎（RA）和普通人群相比，每年 VCF 住院的趋势。使用国家住院患者样本（NIS）数据库（2000-2014 年），根据验证后的 ICD-9 诊断代码，确定成年（≥18 岁）住院患者。评估了三个相互排斥的组别中作为主要诊断的 VCF 住院率：AS、RA 和普通人群。与 RA（0.77%）和普通人群（0.35%）相比，AS 患者 VCF 住院的患病率最高（2.70%）。在 15 年期间，AS 患者 VCF 住院的趋势呈上升趋势（年变化百分比（APC）=4.73，p<0.05），而普通人群呈稳定趋势（APC=0.34，p=NS），RA 呈下降趋势（APC-3.61，p<0.05）。与普通人群相比，AS 相关的 VCF 还与较长的住院时间相关（8.1 天 vs. 5.1 天，p<0.05）和较高的住院死亡率（3.4% vs. 1.0%，p<0.05）。与 RA 相比，AS 患者 VCF 住院率更高且呈上升趋势。需要制定更好的 AS 患者 VCF 风险筛查方法和治疗策略，以减少住院率和相关并发症。关键点 • 与 RA 相比，AS 患者 VCF 住院率呈上升趋势，而 RA 和普通人群呈下降趋势。 • AS 患者的 VCF 与住院时间延长和住院死亡率升高相关，高于 RA 和普通人群。
