Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis.
Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis.
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DOI：
10.1155/2017/6730812
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发表时间：
2017
影响因子：
2.3
通讯作者：
Tohma S
中科院分区：
文献类型：
--
作者：
Hashimoto A;Suto S;Horie K;Fukuda H;Nogi S;Iwata K;Tsuno H;Ogihara H;Kawakami M;Komiya A;Furukawa H;Matsui T;Tohma S
类风湿关节炎(RA)可能会由不同的感染合并，但这些感染的危险因素尚未完全阐明。在这里，我们评估了RA患者中包括肺孢子虫肺炎(PCP)在内的需要住院的感染(IRH)的发生率和危险因素。我们对2009年至2013年在我们医院接受治疗的所有类风湿性关节炎患者进行了回顾性调查，这些患者的人口统计特征、药物、合并症和类风湿性关节炎的严重程度都是可用的。多因素Logistic回归分析用于计算与IRH发生相关因素的调整优势比(OR)。在总计9210个病历(2688个病历)中，共有373个IRH(3.7/100个病历)。呼吸道感染最多见(154例，PCP 16例)，其次为尿路感染(50例)。PCP的重要因素包括较高的年龄(≥70岁；OR3.5)，男性(6.6岁)，潜在的肺部疾病(3.0)，皮质类固醇的使用(4.8)，以及生物制剂的使用(5.4)。甲氨蝶呤的使用(5.7)与PCP呈正相关，而与总感染呈负相关(0.7)。此外，功能障碍和较高的RA疾病活动度也与总感染有关。在决定对个别RA患者进行治疗时，应考虑感染的危险因素。
Rheumatoid arthritis (RA) may be complicated by different infections, but risk factors for these are not fully elucidated. Here, we assessed the incidence of and risk factors for infections requiring hospitalization (IRH) including pneumocystis pneumonia (PCP) in patients with RA. We retrospectively surveyed all RA patients treated at our hospital from 2009 to 2013, for whom data were available on demographic features, medications, comorbidities, and severity of RA. Multivariate logistic regression analysis was applied to calculate adjusted odds ratios (ORs) for factors associated with the occurrence of IRH. In a total of 9210 patient-years (2688 patients), there were 373 IRH (3.7/100 patient-years). Respiratory tract infections were most frequent (n = 154, and additionally 16 PCP), followed by urinary tract infections (n = 50). Significant factors for PCP included higher age (≥70 years; OR 3.5), male sex (6.6), underlying lung disease (3.0), use of corticosteroids (4.8), and use of biologics (5.4). Use of methotrexate (5.7) was positively associated with PCP but negatively with total infections (0.7). Additionally, functional disorders and higher RA disease activity were also related to total infections. Risk factors for infection should be taken into account when deciding treatment for the individual RA patient.