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Abstract: Poster Presentations |

COMORBID RHEUMATOID ARTHRITIS/COLLAGEN VASCULAR DISEASE ASSOCIATED WITH INCREASED IN-HOSPITAL MORTALITY AFTER ACUTE RESPIRATORY FAILURE FREE TO VIEW

David S. Kountz, MD; Yen-Hong Kuo, MS; Nasim Ahmed, MBBS*; Yen-Liang Kuo, MD; John Davis, MD
Author and Funding Information

Jersey Shore University Medical Center, Neptune, NJ


Chest


Chest. 2009;136(4_MeetingAbstracts):16S-b-17S. doi:10.1378/chest.136.4_MeetingAbstracts.16S-b
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Abstract

PURPOSE:  : 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.

METHODS:  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.

RESULTS:  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.

CONCLUSION:  This study found an increased mortality following respiratory failure in patients with rheumatoid arthritis/collagen vascular disease.

CLINICAL IMPLICATIONS:  Patient with RA once develop respiratory failure need close monitoring for higher mortality.

DISCLOSURE:  Nasim Ahmed, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM


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