Hospitalized Infections in Patients With Rheumatic Disease Hospitalizations in Alaska, 2015-2018.
Hospitalized Infections in Patients With Rheumatic Disease Hospitalizations in Alaska, 2015-2018.
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DOI：
10.1002/acr2.11526
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发表时间：
2023-03
影响因子：
3.4
通讯作者：
Holck, Peter
中科院分区：
文献类型：
--
作者：
Ferucci, Elizabeth D;Holck, Peter
风湿性疾病与住院感染率增加有关，但很少有研究包括北美土著人口。我们的目的是评估在阿拉斯加住院期间风湿性疾病诊断与住院感染几率的关系，并评估种族差异。我们使用了2015年至2018年阿拉斯加卫生设施数据报告计划的出院数据。我们根据一组风湿性疾病的出院诊断确定了风湿性疾病诊断的患者，并将其与住院但没有风湿性疾病诊断的患者进行了比较。我们通过风湿性疾病的诊断状态和类型、种族和感染类型来确定住院感染的几率。使用多变量模型，我们确定了与住院感染相关的因素。患有风湿性疾病而不是骨关节炎与住院感染的总体几率高出1.90相关，而患有风湿性疾病的阿拉斯加土著/美洲印第安人（AN/AI）种族的几率高出2.44。风湿性疾病的几率不同，除骨关节炎（0.73）外，所有风湿性疾病的几率均增加。最常见的住院感染类型是败血症，但机会性感染和肺炎与风湿性疾病诊断最相关。在多变量分析中，患有风湿性疾病而非骨关节炎，年龄较大，AN/AI种族与住院感染的几率增加相关，种族和风湿性疾病状态之间存在相互作用。本研究证实了住院期间住院感染与风湿性疾病诊断（骨关节炎除外）的相关性，并确定了种族差异。
Rheumatic diseases are associated with increased rates of hospitalized infection, but few studies have included Indigenous North American populations. Our objective was to evaluate the association of rheumatic disease diagnosis during a hospitalization with odds of hospitalized infections in Alaska and assess differences by race. We used hospital discharge data from the Alaska Health Facilities Data Reporting Program from 2015 to 2018. We identified people with a rheumatic disease diagnosis based on any hospital discharge diagnosis of a set of rheumatic diseases and compared them to people hospitalized but without a rheumatic disease diagnosis. We determined odds of hospitalized infection by rheumatic disease diagnosis status and type, race, and type of infection. Using multivariable modeling, we determined factors associated with hospitalized infection. Having a rheumatic disease diagnosis other than osteoarthritis was associated with 1.90 higher odds of hospitalized infection overall, whereas people of Alaska Native/American Indian (AN/AI) race with rheumatic disease had 2.44 higher odds. The odds varied by rheumatic disease and were increased in all rheumatic diseases except osteoarthritis (0.73). The most common type of hospitalized infection was sepsis, but opportunistic infections and pneumonia were most associated with a rheumatic disease diagnosis. On multivariable analysis, having a rheumatic disease diagnosis other than osteoarthritis, being of older age, and being of AN/AI race were associated with increased odds of hospitalized infection, with an interaction between race and rheumatic disease status. This study confirmed the association of hospitalized infections with rheumatic disease diagnosis (other than osteoarthritis) during hospitalization and identified disparities by race.