Racial/Ethnic variations in morbidity and mortality in Adult Onset Still's Disease: An analysis of national dataset.
Semin Arthritis Rheum
; 49(3): 469-473, 2019 12.
Article
in En
| MEDLINE
| ID: mdl-31109638
ABSTRACT
OBJECTIVES:
Adult Onset Still's Disease (AOSD) is a rare autoinflammatory disorder. There is relatively little known about the impact of social determinants of health on its outcomes. Our goal is to describe the racial/ethnic variations, morbidity and mortality of AOSD hospitalized patients in the US. MATERIALS ANDMETHODS:
Adult US hospitalized patients between 2009-13 from a nationwide inpatient sample (NIS) database with AOSD were identified using ICD-9 code 714.2. NIS is the largest all-payer US inpatient database with approximately 8 million hospitalizations yearly. Patients with other autoimmune diseases were excluded. We used descriptive statistics to summarize patient and hospital characteristics. We performed survey-weighted logistic regression models adjusting for confounders to study our primaryoutcome:
in-hospital mortality.RESULTS:
Between 2009-13, 5,820 AOSD patients were hospitalized with a mean age of 53.6 (SE-0.61) years. 3817 (65.6%) were female, 56% white and 3% Asian. Macrophage Activating Syndrome (1.7%), Disseminated Intravascular Coagulation (DIC-1.1%) and Thrombotic Thrombocytopenic Purpura (0.4%), respectively, complicated the hospital course. There were 154 inpatient deaths in study period (mortality 2.6%). Mean age of patients who died in hospital was higher (62.4 years ± 3.1) and 13.9% were Asians. Patients of Asian origin had significantly higher odds of in-hospital death compared to whites (aORâ¯=â¯6.39, 95% CI 1.77-23.1, pâ¯=â¯0.005). Mortality was significantly higher for patients whose hospital course was complicated by DIC (aORâ¯=â¯29.69, 95% CI 5.5-160.41, pâ¯=â¯0.006).CONCLUSIONS:
In this national sample of patients hospitalized for AOSD, we found significant variations in In-hospital mortality.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ethnicity
/
Registries
/
Still's Disease, Adult-Onset
/
Risk Assessment
/
Racial Groups
Type of study:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
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Female
/
Humans
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Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Semin Arthritis Rheum
Year:
2019
Type:
Article