In-Hospital Mortality Risk Not Increased in Patients With RA After Stroke
Patients with RA who were hospitalized for stroke did not have an increased risk for in-hospital mortality, pneumonia, UTIs, acute respiratory failure, or the use of mechanical ventilation.
Patients with rheumatoid arthritis (RA) who are hospitalized for stroke have an increased risk for peptic ulcers, but do not have an increased risk for in-hospital mortality, pneumonia, urinary tract infections (UTIs), acute respiratory failure, or the use of mechanical ventilation, according to results published in Clinical Rheumatology.
The study included participants with RA who were hospitalized for stroke treatment (n=736) and age- and sex-matched control patients without RA (n=2208). The researchers performed conditional logistic regressions to calculate odds ratios (ORs) for in-hospital mortality and secondary diagnoses of pneumonia, UTIs, peptic ulcers, acute respiratory failure, and the use of mechanical ventilation. The researchers also analyzed length of stay and hospitalization costs.
Compared with controls, participants with RA had a significantly increased risk for peptic ulcers during stroke hospitalizations (OR, 1.52; 95% CI, 1.05-2.20).
The researchers did not find any significant differences between participants with RA and control patients regarding in-hospital mortality, pneumonia, UTIs, acute respiratory failure, or the use of mechanical ventilation. In addition, the length of stay for stroke hospitalization did not differ between participant groups.
Participants with RA had significantly lower medical costs compared with control patients ($1673 vs $1932; P =.038).
The results did indicate that among participants with a subarachnoid/intracerebral hemorrhagic stroke, participants with RA had an increased risk for mechanical ventilation compared with control patients (adjusted OR, 1.89; 95% CI, 1.14-3.15).
"Epidemiological evidence from the present study makes a contribution to understanding the clinical profile and management of RA patients during a stroke hospitalization and should contribute to the development of optimal clinical care guidelines for these patients," the researchers wrote.
Kang J, Xirasagar S, Lin H, et al. Risk of adverse outcomes in patients with rheumatoid arthritis hospitalized for stroke—a cross-sectional study [published online September 12, 2018]. Clin Rheumatol. doi: 10.1007/s10067-018-4287-8