Trends in Hospitalizations for Serious Infections in Patients With Rheumatoid Arthritis in the US Between 1993 and 2013
Trends in Hospitalizations for Serious Infections in Patients With Rheumatoid Arthritis in the US Between 1993 and 2013
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DOI：
10.1002/acr.23328
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发表时间：
2018-04-01
影响因子：
4.7
通讯作者：
Dubreuil, Maureen
中科院分区：
文献类型：
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作者：
Jinno, Sadao;Lu, Na;Dubreuil, Maureen
类风湿性关节炎（RA）患者感染住院的流行病学是未知的，尽管增加RA治疗，赋予感染的风险。MethodsWe检查了1993 - 2013年的全国住院患者样本数据。我们确定了RA成人患者的住院情况，根据国际疾病分类第九次修订版，临床修改代码（714.xx）在任何次要诊断领域进行定义。我们评估了5种感染作为初步诊断：肺炎、败血症、尿路感染（UTI）、皮肤和软组织感染（SSTI）和机会性感染（OI）。主要结果是每种感染的住院比例在所有住院与RA的二次诊断。结果有792，921次住院与RA的二次诊断的感染，从1993年至2013年，每10万人的发病率从90增加到206。肺炎（从5.4%降至4.6%）、UTI（从0.4%降至0.38%）和OI（从0.44%降至0.26%）的住院比例有所下降。因SSTI住院的比例略有增加（从2.3%到2.5%），而因败血症住院的人数增加了两倍多（从1.9%到6.4%）。结论1993年至2013年，类风湿关节炎患者因感染住院的比例似乎下降了肺炎和OIs，UTI略有下降，SSTI略有增加，以及败血症住院率的大幅上升。我们的研究结果与先前的报告一致，脓毒症编码的敏感性随着时间的推移而增加。
ObjectiveThe epidemiology of hospitalizations with infections among patients with rheumatoid arthritis (RA) is unknown, despite an increase in RA treatments that confer a risk of infection.MethodsWe examined National Inpatient Sample data from 1993-2013. We identified hospitalizations among adults with RA, defined by International Classification of Diseases, Ninth Revision, Clinical Modification codes (714.xx) in any secondary diagnosis field. We evaluated 5 infections as the primary diagnosis: pneumonia, sepsis, urinary tract infection (UTI), skin and soft tissue infections (SSTIs), and opportunistic infections (OIs). The primary outcome was the proportion of hospitalizations for each infection among all hospitalizations with a secondary diagnosis of RA.ResultsThere were 792,921 hospitalizations for infection with a secondary diagnosis of RA, with the rates increasing from 90 to 206 per 100,000 persons from 1993-2013. The proportion of hospitalizations decreased for pneumonia (from 5.4% to 4.6%), UTI (from 0.4% to 0.38%), and OIs (from 0.44% to 0.26%). The proportion of hospitalizations for SSTIs increased slightly (from 2.3% to 2.5%), while hospitalizations for sepsis more than tripled (from 1.9% to 6.4%).ConclusionBetween 1993 and 2013, the proportion of hospitalizations for infections among RA patients appeared to decline for pneumonia and OIs, with a slight decrease in UTI, a slight increase in SSTIs, and a substantial increase in hospitalizations with sepsis. Our results are consistent with previous reports that the sensitivity of sepsis coding has increased over time.