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Joint Bone Spine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le dimanche 22 décembre 2019
Doi : 10.1016/j.jbspin.2019.11.005
accepted : 20 November 2019
Risk of preventable hospitalization before and after diagnosis among rheumatoid arthritis patients compared to non-rheumatoid arthritis controls

Chang-Fu Kuo a, b, Patricia B. Burns c, Jung-Sheng Chen b, Lu Wang d, Kevin C. Chung c,
a Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK 
b Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan 
c Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States 
d Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States 

Corresponding author. Section of Plastic Surgery, Michigan Medicine, 2130 Taubman Center, SPC 5340 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5340, United States.Section of Plastic Surgery, Michigan Medicine, 2130 Taubman Center, SPC 5340 1500 E. Medical Center DriveAnn Arbor, MI 48109-5340United States

The purpose of the study is to investigate the risk of preventable hospitalization among patients with rheumatoid arthritis (RA).


We identified 11,852 incident RA patients and 59,260 age-, sex-, and index year-matched controls from the Taiwan National Health Insurance Database. Index date was the RA diagnosis date for cases, which was assigned to their matched controls. The odds ratios (OR) of preventable hospitalizations between RA patients and controls were estimated using a mixed effect model adjusted for age, sex, patient characteristics, Elixhauser comorbidity index, medical utilization and regional medical resources.


The overall annualized incidence of preventable hospitalization in RA patients and controls was 38.7 vs. 20.9 events per 1,000 person-years (adjusted OR, 1.61; 95% confidence interval [CI], 1.51–1.71). The adjusted OR of preventable hospitalization in RA patients compared to matched controls was 1.17 (1.00–1.37) one year prior to RA diagnosis and remained elevated after RA diagnosis. Adjusted ORs (95% CI) for specific preventable hospitalization categories were 1.93 (1.58–2.36) for chronic obstructive pulmonary disease, 1.64 (1.21–2.21) for asthma, 1.95 (1.78–2.13) for bacterial pneumonia, and 1.59 (1.44–1.75) for urinary tract infection. When assessing the trend of individual preventable hospitalizations before and after diagnosis, bacterial pneumonia and urinary tract infection hospitalizations had a significantly higher OR in RA patients one year before diagnosis and five years afterward (adjusted OR ranges 2.75 to 4.48 and 1.83 to 3.07 respectively, all P -values<0.05)


RA is independently associated with a higher risk of preventable hospitalization specifically for chronic lung diseases and infections.

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Keywords : Rheumatoid arthritis, Preventable hospitalization, Biologics

© 2019  Société française de rhumatologie@@#104156@@