英国生物库和苏格兰早期类风湿关节炎（SERA）队列中合并多种疾病的类风湿关节炎患者住院的风险、持续时间和原因的相关性：纵向观察研究。

Association between risk, duration and cause of hospitalisations in people with rheumatoid arthritis and multimorbidity in the UK Biobank and Scottish Early Rheumatoid Arthritis (SERA) cohorts: Longitudinal observational study.

机构信息

School of Infection and Immunity, University of Glasgow, Glasgow, UK.

General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.

出版信息

Semin Arthritis Rheum. 2023 Feb;58:152130. doi: 10.1016/j.semarthrit.2022.152130. Epub 2022 Nov 17.

DOI:10.1016/j.semarthrit.2022.152130

PMID:36459724

Abstract

OBJECTIVES

To investigate association between presence of multimorbidity in people with established and early rheumatoid arthritis (RA) and risk, duration and cause of hospitalisations.

DESIGN

Longitudinal observational study.

SETTING

UK Biobank, population-based cohort recruited between 2006 and 2010, and the Scottish Early Rheumatoid Arthritis (SERA), inception cohort recruited between 2011 and 2015. Both linked to mortality and hospitalisation data.

PARTICIPANTS

4757 UK Biobank participants self-reporting established RA; 825 SERA participants with early RA meeting the 2010 ACR/EULAR classification criteria. Participants stratified by number of long-term conditions (LTCs) in addition to RA (RA only, RA + 1 LTC and RA + ≥ 2 LTCs) and matched to five non-RA controls.

MAIN OUTCOME MEASURES

Number and duration of hospitalisations and their causes. Incidence rate ratios (IRR) and 95% confidence intervals (CI) calculated using negative binomial regression models.

RESULTS

Participants with RA + ≥ 2 LTCs experienced higher hospitalisation rates compared to those with RA alone (UK Biobank: IRR 2.10, 95% CI 1.91 to 2.30; SERA: IRR 1.74, 95% CI 1.23 to 2.48). Total duration of hospitalisation in RA + ≥ 2 LTCs was also higher (UK Biobank: IRR 2.48, 95% CI 2.17 to 2.84; SERA: IRR 1.90, 95% CI 1.07 to 3.38) than with RA alone. Rate and total duration of hospitalisations was higher in UK Biobank RA participants than non-RA controls with equivalent number of LTCs. Hospitalisations for respiratory infection were higher in early RA than established RA and were the commonest cause of hospital admission in early RA.

CONCLUSIONS

Participants with established or early RA with multimorbidity experienced a higher rate and duration of hospitalisations than those with RA alone and with non-RA matched controls.

摘要

目的

探讨已确诊和早期类风湿关节炎（RA）患者中并存多种疾病与住院风险、持续时间和原因的相关性。

设计

纵向观察性研究。

地点

英国生物库，人群为 2006 年至 2010 年期间招募的队列，苏格兰早期类风湿关节炎（SERA），为 2011 年至 2015 年期间招募的队列，均与死亡率和住院数据相关联。

参与者

4757 名英国生物库患者自述患有已确诊的 RA；825 名 SERA 参与者符合 2010 年 ACR/EULAR 分类标准，患有早期 RA。参与者按除 RA 之外的长期疾病（LTC）数量分层（仅 RA、RA+1 LTC 和 RA+≥2 LTC），并与 5 名非 RA 对照相匹配。

主要观察指标

住院次数和持续时间及其原因。使用负二项回归模型计算发病率比（IRR）和 95%置信区间（CI）。

结果

RA+≥2 LTC 患者的住院率高于仅 RA 患者（英国生物库：IRR 2.10，95%CI 1.91 至 2.30；SERA：IRR 1.74，95%CI 1.23 至 2.48）。RA+≥2 LTC 患者的总住院时间也更长（英国生物库：IRR 2.48，95%CI 2.17 至 2.84；SERA：IRR 1.90，95%CI 1.07 至 3.38）。与具有同等数量 LTC 的非 RA 对照相比，英国生物库 RA 患者的住院率和总住院时间更高。与已确诊的 RA 相比，早期 RA 患者的呼吸道感染住院率更高，也是早期 RA 患者住院的最常见原因。