: Patients with rheumatoid arthritis (RA) have a substantially reduced life expectancy which is mainly attributed to cardiovascular disease and infection. Either from underlying disease or as a result of treatment, patients with RA have a higher incidence of pulmonary disease as well. A little is known about the in-hospital mortality after acute respiratory failure (ARF) in this patient population.. We sought to compare the in-hospital mortality after ARF in patents with or without RA.
Adult patients (≥ 18 years) who had emergency admission for ARF during 2003–2006 were identified from the US Nationwide Inpatient Sample database. In-hospital mortality is the primary outcome. Multiple logistic regression models were used to assess the association between comorbid rheumatoid arthritis/collagen vascular disease (RACVD) and in-hospital mortality.
There were 82,121 emergency admissions for ARF. Among them, 1,621 (2%) patients had a history of RACVD. Those patients were younger (mean [standard deviation]: 63.6[16.1] vs. 67.1[15.5] years, P < 0.0001), more likely to be female (76.8% vs. 52.3%, P < 0.0001), but not significantly different in race distribution (P = 0.08). The overall mortality was 24.3%. The RACVD patients did not show a significantly higher mortality rate (24.9% vs. 24.3%, P = 0.61) from univariate analysis. However, from a multiple logistic regression model, RAVCD patients had a significantly higher chance of mortality (odds ratio: 1.21, 95% confidence interval: [1.07, 1.36], P = 0.003), while controlling for gender, race, insurance, admission source, median household income, teaching status, bed size and region of hospital and major comorbidities.
This study found an increased mortality following respiratory failure in patients with rheumatoid arthritis/collagen vascular disease.
Patient with RA once develop respiratory failure need close monitoring for higher mortality.
Nasim Ahmed, No Financial Disclosure Information; No Product/Research Disclosure Information