SAN DIEGO — Much has been made recently of rheumatoid arthritis patients' substantially reduced life expectancy because of cardiovascular disease. Far less widely known is that they also have increased in-hospital mortality following acute respiratory failure.
A study of 22,121 adults in the U.S. Nationwide Inpatient Sample database who had an emergency hospitalization for acute respiratory failure from 2003 to 2006 showed that the 1,621 with comorbid rheumatoid arthritis or collagen vascular disease had an adjusted 21% increased risk of in-hospital mortality, Dr. David S. Kountz reported at the annual meeting of the American College of Chest Physicians.
The unadjusted in-hospital mortality rates in acute respiratory failure patients with or without rheumatoid arthritis or collagen vascular disease were closely similar: 25% in the rheumatologic group, and 24% in the 20,500 patients without such comorbidity. But the rheumatoid arthritis/collagen vascular disease group was younger, wealthier, and far more likely to be female.
After adjustment for these and other potential confounders, such as hospital teaching status, in a multivariate logistic regression analysis, the rheumatoid arthritis/collagen vascular disease group had a significantly greater in-hospital mortality risk, according to Dr. Kountz, senior vice president of medical and academic affairs at the Jersey Shore University Medical Center in Neptune, N.J.
Disclosures: Dr. Kountz having no conflicts of interest in connection with this study.