An Analysis of Rheumatoid Arthritis Hospitalizations

Kannayiram, Sandhya Shri; Guraya, Armaan; Muojieje, Chukwudi Charles; Nair, Karun M; Idolor, Osahon N; Odion, Jesse; Aihie, Osaigbokan P; Sanwo, Eseosa

doi:10.7759/cureus.12344

Cited by 4 publications

(3 citation statements)

References 29 publications

(11 reference statements)

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“…However, there is scant data in the literature on the economic impact of RA for public hospitals. Kannayiram et al and Gil-Conesa et al described the cost of drug therapy for RA by utilizing ICD-9-CM and ICD-10 [ 22 , 23 ], but did not investigate the expenditure of hospital resources for medical procedures and surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Health and economic impact associated with rheumatoid arthritis discharges: a cost analysis of a two-year cohort in Mexico

Mendoza-Gutierrez,

Montiel-Ojeda,

Vargas-Chanes

et al. 2023

BMC Health Serv Res

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Background Rheumatoid arthritis is a highly prevalent disease. Patients undergo various medical and pharmacological treatments, which have an economic impact on hospitals. The aim of this study was to estimate the direct economic costs of Mexican Social Security Institute (IMSS) resources used to provide healthcare to adult patients with rheumatoid arthritis in 2016–2017. Methods Data of patients aged > 18 years with Rheumatoid Arthritis (RA) were obtained from databases and public information sources to estimate the use of IMSS resources for the target population. Total costs were estimated by means of the macro-costing method, employing the diagnosis-related group (DRG). Each DRG of the IMSS was constructed with one of the diagnoses and the respective combination of clinical characteristics included in the ICD-9. This study was conducted from the national perspective of IMSS, the largest healthcare service administrator in the country. As such, it can be considered representative of the broader healthcare landscape in Mexico. Results The total cost per year of furnishing inpatient care to RA patients was found to be $170,099,794 MXN ($9,096,245.67 USD) for 2016 and $167,039,481 MXN ($8,932,592.57 USD) for 2017, implying an enormous economic impact on the government budget for Mexican public health services. Conclusions Our results demonstrate that the direct costs of musculoskeletal and cardiovascular surgery represented the highest costs of RA in-hospital care at IMSS (the largest health institution in Mexico) in 2016 and 2017. Further studies are needed that include the cost of drugs and other indirect costs in addition to our results to get the most accurate approximation of the cost of living with RA.

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Section: Discussionmentioning

confidence: 99%

Health and economic impact associated with rheumatoid arthritis discharges: a cost analysis of a two-year cohort in Mexico

Mendoza-Gutierrez,

Montiel-Ojeda,

Vargas-Chanes

et al. 2023

BMC Health Serv Res

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“…Second, sepsis was identified by using ICD codes, similar to other epidemiological studies using administrative data [ 22 ], and not from clinical records, an inherent limitation of administrative data. Third, although the ICD codes for RA in the present report were used in prior epidemiological studies [ 23 , 24 ], misclassification may have occurred between groups. However, misclassifying RA hospitalizations would have likely reduced differences in outcomes between sepsis hospitalizations with and without RA.…”

Section: Discussionmentioning

confidence: 99%

“…The primary exposure was a diagnosis of RA. Hospitalizations with RA were identified based on the presence of ICD-9-CM and ICD-10-CM codes 714.0, 714.1, 714.2, 714.8x, or 714.9, and M05x or M06x, respectively, in the principal or secondary diagnosis fields [ 23 , 24 ]. The primary outcome was short-term mortality, defined as in-hospital death or discharge to hospice.…”

Section: Methodsmentioning

confidence: 99%

The prognostic impact of rheumatoid arthritis in sepsis: a population-based analysis

Oud¹,

Garza

2022

Acute Crit Care

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Background: Rheumatoid arthritis (RA) is associated with increased risk of sepsis and higher infection-related mortality compared to the general population. However, the evidence on the prognostic impact of RA in sepsis has been inconclusive. We aimed to estimate the population-level association of RA with short-term mortality in sepsis. Methods: We used statewide data to identify hospitalizations aged ≥18 years in Texas with sepsis, with and without RA during 2014-2017. Hierarchical logistic models with propensity adjustment (primary model), propensity score matching, and multivariable logistic regression without propensity adjustment were used to estimate the association of RA with short-term mortality among sepsis hospitalizations. Results: Among 283,025 sepsis hospitalizations, 7,689 (2.7%) had RA. Compared to sepsis hospitalizations without RA, those with RA were older (aged ≥65 years, 63.9% vs. 56.4%) and had higher burden of comorbidities (mean Deyo comorbidity index, 3.2 vs. 2.7). Short-term mortality of sepsis hospitalizations with and without RA was 26.8% vs. 31.4%. Following adjustment for confounders, short-term mortality was lower among RA patients (adjusted odds ratio [aOR], 0.910; 95% confidence interval [CI], 0.856-0.967), with similar findings on alternative models. On sensitivity analyses, short-term mortality was lower in RA patients among sepsis hospitalizations aged ≥65 years and those with septic shock, but not among those admitted to intensive care unit (ICU; aOR, 0.990; 95% CI, 0.909-1.079). Conclusions: RA was associated, unexpectedly, with lower short-term mortality in septic patients. However, this "protective" association was driven by those patients without ICU admission. Further studies are warranted to confirm these findings and to examine the underlying mechanisms.

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Effect of thrombocytosis on cardiovascular risk in rheumatoid arthritis

Mazurov

Melnikov

Morozova³

2023

HERALD of North-Western State Medical University named after I.

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BACKGROUND: Patients with rheumatoid arthritis have a high level of comorbidity, and their most common and socially significant conditions are cardiovascular diseases, which represent a major cause of mortality. Currently, there are no data on the differences in cardiovascular risk scales in patients with rheumatoid arthritis depending on the presence or absence of thrombocytosis. AIM: To assess and compare cardiovascular risk according to conventional scales in patients with thrombocytosis and normal thrombocytes. MATERIALS AND METHODS: The study involved 85 patients diagnosed with rheumatoid arthritis: 40 with thrombocytosis [including 25 (62,5%) women] and 45 with normal thrombocytes [including 29 (64,4%) women]. The following scales were used to assess risk of cardiovascular complications: Systematic COronary Risk Evaluation with adjustment factor 1.5 (mSCORE), Reynolds Risk Score (RRS), QRESEARCH Cardiovascular Risk Algorithm (QRISK3), Assessing Cardiovascular Risk to Scottish Intercollegiate Guidelines Network / SIGN to Assign Preventative Treatment (ASSIGN). RESULTS: The obtained findings have demontrated that according to the mSCORE and RRS scales the patients of both groups had almost identical parameters; however, according to the ASSIGN and QRISK3 high risk of cardiovascular complications has been detected nearly twice as frequently in the patients with rheumatoid arthritis and thrombocytosis in comparison with those with normal level of thrombocytes. It is also worth noting that more frequent determination of high risk of cardiovascular complications by the QRISK3 was statistically significant. CONCLUSIONS: The QRISK3 calculation has shown significantly higher prevalence of high-risk cardiovascular complications among the patients with platelet counts 450 ∙ 109/l compared with those with platelet levels within the reference values. Thus, the QRISK3 scale can be considered as more informative for estimating risk of cardiovascular complications in rheumatoid arthritis.

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An Analysis of Rheumatoid Arthritis Hospitalizations

Cited by 4 publications

References 29 publications

Health and economic impact associated with rheumatoid arthritis discharges: a cost analysis of a two-year cohort in Mexico

Health and economic impact associated with rheumatoid arthritis discharges: a cost analysis of a two-year cohort in Mexico

The prognostic impact of rheumatoid arthritis in sepsis: a population-based analysis

Effect of thrombocytosis on cardiovascular risk in rheumatoid arthritis

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