Causes and types of disease in elderly patients leading to one or multiple hospital admissions in rheumatology wards of southwestern Iran: A 6-year review

Abstract

Personal non-commercial use only.Rheumatology Research Journal. Copyright © 2019. All rights reserved *Corresponding Author: Saeedeh Shenavandeh, MD, Department of internal medicine, division of rheumatology Shiraz University of Medical Sciences, Namazee Hospital, Shiraz, Iran. Email: shenavande@sums.ac.ir, Tel/Fax: (+98)713-6474316 Po Box: 71345-1414. Received: 12 April 2018 ; Accepted: 20 November 2018 The physiological changes associated with aging and the presence of comorbid diseases may complicate the treatment of elderly patients with rheumatic diseases. This study aimed to determine the prevalence and main causes of admissions of elderly patients to rheumatology wards and the number and duration of their hospitalizations. Data was collected on patients aged ≥ 60 who were admitted to rheumatology wards from 2008 to 2013. To make a good comparison, the last diagnoses of younger patients admitted to these wards were also recorded. In the elderly group, the records of 399 patients admitted to hospitals with a flare-up of a new or known case of rheumatoid arthritis (RA) were compared with those of 480 young patients. No significant difference was seen between these two groups in the duration of hospital stay. In the elderly group, hypertension (62.4%) was the most common comorbidity. The presence of psychiatric problems showed a significant association with the number of admissions (P value=0.037) as well as patients receiving infliximab, rituximab, and IV IG (P value=<0.001). Recurrent admissions were seen mostly in patients with psoriatic arthritis (PsA), polymyositis, and Behçet’s disease. Flare-ups or new diagnoses of RA were the most prevalent causes for the admission of elderly patients to rheumatology wards. Recurrent admissions were seen mostly in patients with PsA and were associated with the presence of psychiatric problems and a need for IV medications. The results highlight the need for healthcare centers to support outpatient clinics for elderly patients.