Bharadiya Vishwesh, Berry Parul, Singh Aman Dev, Feterman Dominique, Hughes Grant, Bays Alison, Stovall Rachael, Dhital Rashmi, Singh Namrata
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Mayo Clinic, Rochester, Minnesota.
ACR Open Rheumatol. 2025 May;7(5):e70043. doi: 10.1002/acr2.70043.
Patients with rheumatoid arthritis (RA) frequently visit emergency departments (EDs), but their clinical characteristics and admission factors are poorly understood. Our study investigates the epidemiology and outcomes of ED visits among patients with RA using the Nationwide Emergency Department Sample (NEDS).
This cross-sectional study used the 2019 NEDS data to identify RA-related ED visits using International Classification of Disease, Tenth Revision codes M05.X or M06.X. RA-related ED visits were defined as encounters in which RA was recorded in any diagnostic position. Demographics, clinical features, and comorbidities were compared between RA and non-RA ED visits. Racial variations were assessed, and multivariable logistic regression identified factors associated with inpatient admission.
We identified 905,811 (0.8%) ED visits for adults aged ≥18 years with RA. Compared to non-RA visits, RA ED visits had a higher proportion of patients aged ≥65 years, women, White patients, and Medicare-insured individuals with a greater comorbidity burden. Admission rates were 46% for RA visits versus 16% for non-RA visits. Black and Hispanic patients with RA were younger than White patients and more likely to belong to the lowest income quartile. Older age, male sex, and comorbidities were associated with higher admission odds, whereas Black race, lowest income quartile, and Medicaid coverage correlated with lower odds of admission. Septicemia was the most common primary ED diagnosis in patients with RA.
Patients with RA visiting the ED were older, had a higher comorbidity burden, and were three times more likely to be admitted than patients without RA. Black patients and those in the lowest income quartile had lower odds of admission, highlighting potential disparities and the need for targeted interventions to improve health equity.
类风湿关节炎（RA）患者经常前往急诊科（ED）就诊，但对其临床特征和入院因素了解甚少。我们的研究使用全国急诊科样本（NEDS）调查RA患者急诊科就诊的流行病学情况及结局。
这项横断面研究使用2019年NEDS数据，通过国际疾病分类第十版编码M05.X或M06.X识别与RA相关的急诊科就诊情况。与RA相关的急诊科就诊定义为在任何诊断位置记录有RA的就诊。比较了RA与非RA急诊科就诊患者的人口统计学、临床特征和合并症情况。评估了种族差异，并通过多变量逻辑回归确定与住院入院相关的因素。
我们识别出905,811例（0.8%）年龄≥18岁的成人RA患者的急诊科就诊情况。与非RA就诊相比，RA急诊科就诊患者中≥65岁的患者、女性、白人患者以及合并症负担较重的医疗保险参保者比例更高。RA就诊的入院率为46%，而非RA就诊的入院率为16%。患有RA的黑人和西班牙裔患者比白人患者年轻，且更有可能属于收入最低的四分位数。年龄较大、男性以及合并症与较高的入院几率相关，而黑人种族、收入最低的四分位数以及医疗补助覆盖与较低的入院几率相关。败血症是RA患者最常见的主要急诊科诊断。
前往急诊科就诊的RA患者年龄较大，合并症负担较重，入院可能性是无RA患者的三倍。黑人患者和收入最低四分位数的患者入院几率较低，这突出了潜在的差异以及需要有针对性的干预措施来改善健康公平性。
