Risk and predictors of infection leading to hospitalisation in a large primary-care-derived cohort of patients with inflammatory polyarthritis

Abstract

Background: The increased mortality observed in patients with rheumatoid arthritis is partly due to an increased occurrence of serious infections. A retrospective study from the Mayo Clinic found that infection risk is increased in rheumatoid arthritis. In particular, serious infection was associated with severe disease and use of corticosteroids. Robust estimates are required from prospective studies of incident cases. Objective: To examine the risk of infection leading to hospitalisation and potential factors associated with this risk in an unselected population of patients with inflammatory polyarthritis. Design: A prospective cohort study comparing infection incidence in new-onset patients with inflammatory polyarthritis with local population experience. Patients and methods: 2108 patients with inflammatory polyarthritis from a community-based register were studied and followed up annually (median 9.2 years). The rate of hospitalisations for serious infection was compared with the rate of hospitalisations in the regional population. The contribution of potential predictors was assessed by undertaking a within-cohort analysis. Results: Overall, the incidence of infection was more than two and a half times that of the general population (varying by site). History of smoking, corticosteroid use and rheumatoid factor were found to be significantly independent predictors of infection-related hospitalisation. Patients with inflammatory polyarthritis with all three factors were more than seven times as likely to be hospitalised compared with the rest of the cohort. Discussion: These findings provide background data on the risk of infection associated with rheumatoid arthritis, and are of particular interest given the current awareness of the risk of infection associated with antitumour necrosis factora treatments.

Association of Dialysis Modality with Risk for Infection-Related Hospitalization

“…Few studies are aimed at determining the risk factors for IRH. Some reported risk factors are age (6,8,16), diabetes (2,6,8,16,19), serum albumin level (2,6,8,16), temporary catheters (16), arteriovenous grafts (16), black race (8,16), no insurance (16), decreased hematocrit levels (20), higher use of erythropoietin (20), high comorbidity score (2), smoking (21), pulmonary disease (6), and corticosteroid use (21). We found an increased risk only with diabetes.…”

Immunization With a Pneumococcal Polysaccharide Vaccine in Children With Juvenile Idiopathic Arthritis Without Systemic Manifestations: a Prospective Study

“…2017; 16 (6): 493-501. doi: 10.15690/vsp.v16i6.1822) ОБОСНОВАНИЕ Ювенильный идиопатический артрит (ЮИА) -хро-ническое иммуноагрессивное воспалительное забо-левание, которое при отсутствии лечения приводит к необратимому повреждению суставов [1]. Пациенты с ЮИА имеют повышенный риск развития инфекций [2][3][4][5], обусловленный иммунологической дисфунк-цией, воздействием мощных иммунодепрессантов и активностью болезни [6][7][8]. Результаты исследова-ний демонстрируют, что противоревматические пре-параты, применяемые для лечения ЮИА, увеличивают риск развития инфекционных заболеваний [8,9].…”

How to reduce morbidity and mortality from chest infections in rheumatoid arthritis

“…[2][3][4][5] Morbidity from sepsis is common and a prevalence as high as 45% over 10 years has been reported. 6,7 An increase in hospitalisation for serious infections among patients with RA has recently been confirmed in a longitudinal cohort where risk factors included the presence of extra articular manifestations and prior use of oral steroids. 8,9 A high incidence of lower respiratory tract infections (LRTI) in RA patients as compared to controls, with a resulting increased mortality, has recently been confirmed.…”