AB0332 Comorbidities prevalence and charlson index in a cohort of patients with rheumatoid arthritis

Abstract

BackgroundThe Charlson comorbidity index (CCI) is a prognostic scale, which gives a numerical value that indicates the burden of comorbidities in a patient. This index is obtained from the sum of 19 medical conditions that have been related to mortality and has been validated in several studies. Patients with rheumatoid arthritis (RA) are more at risk than the general population of developing comorbidities. However, these often go unnoticed despite the impact on the disease activity and to treatment response, as shown by different studies such as COMORA.ObjectivesTo determine the prevalence of comorbidities in a cohort of patients with RA and estimate CCI.MethodsCross-sectional descriptive study, patients diagnosed with RA according to the EULAR/ACR 2010 classification criteria were included. All patients were followed up in a rheumatology service in a tertiary hospital. Comorbidities were obtained from the medical records. To measure comorbidities, CCI was calculated, the diagnosis of RA was not included in the index. We defined three categories of comorbidity according to CCI: 0 (no comorbidity, applied to patients with no previous record of conditions included in the CCI), 1 to 2 (moderate) and 3 or more (severe). Others comorbidities not included in CCI, such as hypertension (HTN), dyslipidemias (DLP), thyroid disease (TD), osteoporosis (OP) were collected.Results130 patients (103 women) were analysed; mean age was 58.6±12.9 years and disease duration of 6.0±4.4 years. 82.8% were seropositive for rheumatoid factor (n: 83) and/or anti-CCP (n: 97). 44.6% had previous smoking history, 22 were current smokers. The most observed comorbidities in our cohort were: overweight and obesity (BMI ≥25; 63%), DLP (38.8%), HTN (31.5%), chronic kidney disease (32.3%; 6.9% ≥Stage III) and chronic lung disease (23.8%). Other diseases included TD (18.5%), OP (17.7%), diabetes mellitus (9.2%) and liver disease (9.2%). Five patients with a history of tumour (2 metastases) and 2 lymphomas in the last 5 years. Four patients had a heart disease, in 3 as an ischaemic event.According to CCI, 20.8% of the patients had a Charlson 0, 43.8% Charlson 1–2, and 35.4% Charlson ≥3.ConclusionsIn our cohort, despite being a relatively young population, the presence of comorbidities and cardiovascular risk factors is relatively high, in agreement with what has been observed in other studies. 1 out of 3 patients has a severe comorbidity burden.Disclosure of InterestNone declared

Comparative Overall Comorbidity Burden Among Patients With Hidradenitis Suppurativa

“…Disease states with similar CCI indices to HS include systemic lupus erythematosus (CCI score, 1.43), dermatomyositis (CCI score, 1.4), and ankylosing spondylitis (CCI score, 1.33) . In rheumatoid arthritis, 35.4% of patients have a CCI score of at least 3, compared with the nearly 1 in 4 (912 [23.9%]) patients with HS in this risk category. The mortality risk observed in our analysis is consistent with prior studies in other disease states in which CCI scores of at least 5 are associated with a 5- to 7-fold increase in 5-year mortality risk, as well as a 5-fold increase in annual health care expenditures …”

Associated comorbidities of patients with Rheumatoid Arthritis in external consulation

“…YJFS: diseño, corrección metodológica, revisión del manuscrito. índice de Charlson, la HTA y sobrepeso/obesidad, en la literatura con respecto a este particular encontramos similitudes con el estudio de Azuaga Piñango et al quienes analizaron 130 pacientes con diagnóstico de AR en España y demostraron que las comorbilidades más observadas en esa cohorte fueron sobrepeso y obesidad (63%), dislipidemia (38,8%), HTA (31,5%) y enfermedad renal crónica (32,3%) 22 . Otro estudio realizado por Tiippana-Kinnunen, et al (2013) donde estudiaron comorbilidades en 80 pacientes finlandeses con AR con un seguimiento de 15 años, y demostraron que la comorbilidad más frecuente fue HTA 23 .…”