Disease activity and low physical activity associate with number of hospital admissions and length of hospitalisation in patients with rheumatoid arthritis

Abstract

IntroductionSubstantial effort has been devoted for devising effective and safe interventions to reduce preventable hospital admissions in chronic disease patients. In rheumatoid arthritis (RA), identifying risk factors for admission has important health policy implications, but knowledge of which factors cause or prevent hospital admissions is currently lacking. We hypothesised that disease activity/severity and physical activity are major predictors for the need of hospitalisation in patients with RA.MethodsA total of 244 RA patients were assessed for: physical activity (International Physical Activity Questionnaire), RA activity (C-reactive protein: CRP; disease activity score: DAS28) and disability (Health Assessment Questionnaire: HAQ). The number of hospital admissions and length of hospitalisation within a year from baseline assessment were collected prospectively.ResultsDisease activity and disability as well as levels of overall and vigorous physical activity levels correlated significantly with both the number of admissions and length of hospitalisation (P < 0.05); regression analyses revealed that only disease activity (DAS28) and physical activity were significant independent predictors of numbers of hospital admissions (DAS28: (exp(B) = 1.795, P = 0.002 and physical activity: (exp(B) = 0.999, P = 0.046)) and length of hospitalisation (DAS28: (exp(B) = 1.795, P = 0.002 and physical activity: (exp(B) = 0.999, P = 0.046). Sub-analysis of the data demonstrated that only 19% (n = 49) of patients engaged in recommended levels of physical activity.ConclusionsThis study provides evidence that physical activity along with disease activity are important predictors of the number of hospital admissions and length of hospitalisation in RA. The combination of lifestyle changes, particularly increased physical activity along with effective pharmacological therapy may improve multiple health outcomes as well as cost of care for RA patients.

Thirty-day complications in rheumatoid patients following total knee arthroplasty

“…Anemia of chronic disease, iron deficiency anemia, and bone marrow suppression secondary to medications, which are common findings in patients with RA, are thought to play a role in this increased requirement [16,17]. Similar to the present study, Stundner et al and Elke et al found that the total length of surgical stay was significantly higher in rheumatoid patients (mean of 3.6 vs. 3.5 days, and median of 25 vs. 23 days; p<0.05) [18][19][20][21][22][23]. Although consistent with our study in terms of longer lengths of stay in the RA cohort, the study by Elke et [24].…”

A systematic review of the factors associated with the initiation of biologicals in patients with rheumatological conditions

“…However, this may not be indicative of actual clinical practice due to the study’s small sample size, as well as simulation of cases with limited information provided. Radiographic progression,37 greater disability (HAQ score),38 lower quality of life (SF36 score),39 positivity of anti-citrullinated protein antibody,40 higher level of acute phase reactant,41 history of hospitalisation42 and higher prevalence of sick leave43 are all indicators associated with higher disease activity. Thus it is no surprise that these factors were also found to be positively associated with biologicals' initiation.…”

Körperliche Aktivität und Sport bei Rheumatoider Arthritis

“…Auch wenn es bei Beendigung der Übungstherapien im weiteren Verlauf zwangsläufi g erneut zu einer Verschlechterung von Fitness und Muskelkraft kommt, zeigt sich dennoch ein verbessertes Niveau im Vergleich zum ursprünglichen Ausgangszustand [ 45 ] . Die muskuloskeletale Funktion ist durchaus prädiktiv für Morbidität und Mortalität, so weist beispielsweise bei Patienten mit rheumatoider Arthritis der Grad der körperlichen Aktivität neben der Krankheitsaktivität eine Korrelation mit der Häufi gkeit und Dauer von Hospitalisationen [ 46 ] auf.…”