Yale University School of Medicine, New Haven, CT, USA.
Yale Center for Analytical Science, Yale School of Public Health, New Haven, CT, USA.
Clin Exp Rheumatol. 2023 Mar;41(2):261-266. doi: 10.55563/clinexprheumatol/791fq8. Epub 2022 Nov 9.
Inclusion body myositis (IBM) is the most common idiopathic inflammatory myopathy (IIM) above the age of 50 with a distinct clinical phenotype of progressive, painless, asymmetric weakness predominantly involving the long finger flexors and quadriceps. In this study, we compared comorbidities in IBM with other IIMs (i.e., dermatomyositis (DM) and polymyositis (PM)) from the United States National Inpatient Sample Database.
We identified patients with a primary diagnosis of IBM or IIM from the National Inpatient Sample (NIS) from 2012 to 2018. We then compared the rate of common inpatient comorbidities between the IBM and IIM.
There were 18,819 admissions for patients with either IBM or IIM. IBM patients were older (72.9±10.7 years vs. 59.3±18.4 years for IIM, p<0.001), predominantly men (65.0% vs. 31.2% for IIM, p<0.001), and White Caucasians (82.5% vs. 58.4% for IIM, p<0.001). IBM patients had significantly more frequent events of aspiration pneumonia, atrial fibrillation, falls, and sepsis. The rate of PEG tube placement was also significantly higher. When performing multivariable logistic regression, we found that IBM is a risk factor for aspiration pneumonia (OR 3.03), PEG tube placement (OR 2.91), falls (OR 2.05), and sepsis (OR 1.30) but not for significant cardiovascular events.
IBM increases a patient's risk for dysphagia, falls, and infection as compared to other IIM patients. Further population-based studies are warranted to better elucidate the impact of these comorbidities in patients with IBM.
包涵体肌炎(IBM)是 50 岁以上最常见的特发性炎性肌病(IIM),其独特的临床表型为进行性、无痛性、不对称性肌无力,主要累及长指屈肌和股四头肌。在本研究中,我们比较了美国国家住院患者样本数据库中 IBM 与其他 IIM(即皮肌炎(DM)和多发性肌炎(PM))的合并症。
我们从 2012 年至 2018 年从国家住院患者样本(NIS)中确定了 IBM 或 IIM 的主要诊断患者。然后,我们比较了 IBM 和 IIM 之间常见住院合并症的发生率。
共有 18819 例 IBM 或 IIM 患者入院。IBM 患者年龄更大(72.9±10.7 岁 vs. IIM 的 59.3±18.4 岁,p<0.001),主要为男性(65.0% vs. IIM 的 31.2%,p<0.001)和白种人(82.5% vs. IIM 的 58.4%,p<0.001)。IBM 患者发生吸入性肺炎、心房颤动、跌倒和败血症的频率明显更高。PEG 管放置的比例也明显更高。进行多变量逻辑回归后,我们发现 IBM 是吸入性肺炎(OR 3.03)、PEG 管放置(OR 2.91)、跌倒(OR 2.05)和败血症(OR 1.30)的危险因素,但不是严重心血管事件的危险因素。
与其他 IIM 患者相比,IBM 增加了患者发生吞咽困难、跌倒和感染的风险。需要进一步进行基于人群的研究,以更好地阐明这些合并症对 IBM 患者的影响。