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Decreases in rates of hospitalizations for manifestations of severe rheumatoid arthritis, 1983–2001

Decreases in rates of hospitalizations for manifestations of severe rheumatoid arthritis, 1983–2001 Objective To determine whether the rates of hospitalization for 4 manifestations of severe rheumatoid arthritis (RA), which are used as indicators of long‐term health outcomes, have changed from 1983 to 2001. Methods Data on all patients with RA who were hospitalized with rheumatoid vasculitis or to undergo splenectomy for Felty's syndrome, cervical spine fusion for myelopathy, or total knee arthroplasty at hospitals in California were abstracted from a state hospitalization database. Changes in rates of hospitalization from 1983 to 2001 were examined in this serial cross‐sectional study. Results Rates of hospitalization for rheumatoid vasculitis and splenectomy in Felty's syndrome decreased progressively over time. The risk of hospitalization for rheumatoid vasculitis was one‐third lower in 1998–2001 than in 1983–1987. The risk of hospitalization for splenectomy in Felty's syndrome was 71% lower in 1998–2001 than in 1983–1987. There were no significant decreases in the rates of hospitalization for cervical spine surgery or total knee arthroplasty (primary and revision), although in 1998–2001 there was a reversal of the trend of increasing rates of total knee arthroplasty. The risk of hospitalization for primary total knee arthroplasty was significantly lower in 1998–2001 than in 1990–1993 (rate ratio 0.90, 95% confidence interval 0.86–0.95; P < 0.0001). Conclusion Rates of hospitalization for rheumatoid vasculitis and splenectomy in Felty's syndrome have decreased over the past 19 years, and there has been a recent decrease in the rates of primary total knee arthroplasty in patients with RA. Although several factors may account for these decreases, these findings suggest that since the early 1980s, the long‐term health outcomes of patients with RA have improved. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Arthritis & Rheumatism Wiley

Decreases in rates of hospitalizations for manifestations of severe rheumatoid arthritis, 1983–2001

Ward, Michael M.
Arthritis & Rheumatism , Volume 50 (4) – Apr 1, 2004
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References (43)

Publisher
Wiley
Copyright
Copyright © 2004 by the American College of Rheumatology
ISSN
0004-3591
eISSN
1529-0131
DOI
10.1002/art.20158
pmid
15077294
Publisher site
See Article on Publisher Site

Abstract

Objective To determine whether the rates of hospitalization for 4 manifestations of severe rheumatoid arthritis (RA), which are used as indicators of long‐term health outcomes, have changed from 1983 to 2001. Methods Data on all patients with RA who were hospitalized with rheumatoid vasculitis or to undergo splenectomy for Felty's syndrome, cervical spine fusion for myelopathy, or total knee arthroplasty at hospitals in California were abstracted from a state hospitalization database. Changes in rates of hospitalization from 1983 to 2001 were examined in this serial cross‐sectional study. Results Rates of hospitalization for rheumatoid vasculitis and splenectomy in Felty's syndrome decreased progressively over time. The risk of hospitalization for rheumatoid vasculitis was one‐third lower in 1998–2001 than in 1983–1987. The risk of hospitalization for splenectomy in Felty's syndrome was 71% lower in 1998–2001 than in 1983–1987. There were no significant decreases in the rates of hospitalization for cervical spine surgery or total knee arthroplasty (primary and revision), although in 1998–2001 there was a reversal of the trend of increasing rates of total knee arthroplasty. The risk of hospitalization for primary total knee arthroplasty was significantly lower in 1998–2001 than in 1990–1993 (rate ratio 0.90, 95% confidence interval 0.86–0.95; P < 0.0001). Conclusion Rates of hospitalization for rheumatoid vasculitis and splenectomy in Felty's syndrome have decreased over the past 19 years, and there has been a recent decrease in the rates of primary total knee arthroplasty in patients with RA. Although several factors may account for these decreases, these findings suggest that since the early 1980s, the long‐term health outcomes of patients with RA have improved.

Journal

Arthritis & Rheumatism – Wiley

Published: Apr 1, 2004

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