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2011年至2021年波兰重症监护病房或心脏重症监护病房中类风湿关节炎患者的住院情况:一项人群研究。

Hospitalizations of patients with rheumatoid arthritis in Polish intensive care units or cardiac intensive care units in the years 2011-2021: a population study.

作者信息

Domańska-Poboża Julia, Kapica Łukasz, Kanecki Krzysztof, Nitsch-Osuch Aneta, Goryński Paweł, Wisłowska Małgorzata

机构信息

Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warszawa, Poland

Department of Ergonomics, Central Institute for Labour Protection – National Research Institute, Warszawa, Poland

出版信息

Pol Arch Intern Med. 2025 Mar 24;135(3). doi: 10.20452/pamw.16913. Epub 2025 Jan 2.

Abstract

INTRODUCTION

Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with significant comorbidities, including cardiovascular and respiratory complications, leading to increased hospitalization rates in intensive care units (ICUs) and cardiac intensive care units (CICUs). This study examines factors related to ICU/CICU admissions among Polish patients with RA from 2011 to 2021.

OBJECTIVES

We aimed to analyze trends in ICU/CICU admissions, identify key factors influencing outcomes, and assess the impact of comorbidities on RA patient ICU/CICU mortality in critical care settings.

PATIENTS AND METHODS

This retrospective population‑based study utilized data from the Polish national hospital morbidity registry. Inclusion criteria comprised ICU/CICU admission and an International Classification of Diseases, Tenth Revision code for RA. A total of 3066 hospitalization records were analyzed, focusing on demographics, length of stay, primary diagnosis, and ICU/CICU mortality rates. A logistic regression was used to evaluate the predictors of ICU/CICU mortality.

RESULTS

The study revealed a rising trend in ICU/CICU admissions, with a significant increase in 2021, potentially due to the COVID‑19 pandemic. The overall ICU/CICU mortality rate was 39.1%, with the highest values observed in patients with gastrointestinal (58.5%) and endocrine / metabolic diseases (61.5%). Urgent admissions and older age were strong predictors of ICU/CICU mortality (P <0.001), while sex was not a significant factor.

CONCLUSIONS

Our findings emphasize the need for early intervention and comprehensive management strategies to mitigate severe RA complications. Future research should explore long‑term outcomes and the impact of RA treatments on ICU/CICU care.

摘要

引言

类风湿性关节炎(RA)是一种慢性自身免疫性疾病,伴有包括心血管和呼吸系统并发症在内的显著合并症,导致重症监护病房(ICU)和心脏重症监护病房(CICU)的住院率增加。本研究调查了2011年至2021年波兰RA患者入住ICU/CICU的相关因素。

目的

我们旨在分析ICU/CICU入院趋势,确定影响预后的关键因素,并评估合并症对危重症环境下RA患者ICU/CICU死亡率的影响。

患者与方法

这项基于人群的回顾性研究利用了波兰国家医院发病率登记处的数据。纳入标准包括入住ICU/CICU以及国际疾病分类第十版中RA的编码。共分析了3066份住院记录,重点关注人口统计学、住院时间、主要诊断和ICU/CICU死亡率。采用逻辑回归评估ICU/CICU死亡率的预测因素。

结果

研究显示ICU/CICU入院呈上升趋势,2021年显著增加,这可能归因于新冠疫情。总体ICU/CICU死亡率为39.1%,胃肠道疾病(58.5%)和内分泌/代谢疾病(61.5%)患者的死亡率最高。紧急入院和高龄是ICU/CICU死亡率的有力预测因素(P<0.001),而性别不是显著因素。

结论

我们的研究结果强调了早期干预和综合管理策略以减轻严重RA并发症的必要性。未来的研究应探索长期预后以及RA治疗对ICU/CICU护理的影响。

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