类风湿性关节炎增加老年髋部骨折患者的并发症风险..:日本全国医疗索赔数据库研究。

IF 1.8 4区 医学 Q3 RHEUMATOLOGY
Yu Mori, Kunio Tarasawa, Hidetatsu Tanaka, Naoko Mori, Ryuichi Kanabuchi, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori
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引用次数: 0

摘要

目的:类风湿性关节炎(RA)是一种常见的自身免疫性疾病,其特点是慢性炎症和关节周围骨质流失,导致全身性骨质疏松症和骨折易感性增加,尤其是老年人的髋部骨折。本研究旨在评估RA患者与非RA患者髋部骨折的相关结果和并发症:利用日本国家行政诊断程序组合(DPC)数据库,我们对2016年4月至2023年3月期间的股骨颈骨折病例进行了研究。在对年龄、性别和并发症进行一至三项倾向评分匹配后,我们研究了髋部骨折老年患者住院期间RA、并发症和死亡率之间的关联:结果:研究结果表明,在多变量逻辑回归分析中,日本老年髋部骨折 RA 患者的肺炎并发症明显高于无 RA 的老年髋部骨折患者,比值为 1.232(95% CI:1.065-1.426,P=0.0056),肺栓塞的比值为 1.155(95% CI:1.036-1.287,P=0.009)。虽然没有明显升高,但研究还发现住院期间死亡率有升高的趋势,比值为 1.179(95% CI:0.973-1.429,p=0.096):一项基于日本 DPC 数据库的实质性研究显示,RA 与并发症(包括肺炎和肺栓塞)增加之间存在显著关联。另一方面,老年 RA 患者因髋部骨折住院期间的死亡风险呈不显著但较高的趋势。在治疗RA患者髋部骨折的过程中,实施预防策略对减少并发症至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rheumatoid arthritis increases complication risks in elderly hip fracture patients.: A Japanese nationwide medical claims database study.

Objectives: Rheumatoid arthritis (RA) is a common autoimmune disorder characterized by chronic inflammation and periarticular bone loss, leading to systemic osteoporosis and heightened fracture susceptibility, especially hip fractures among the elderly. This study aimed to evaluate the outcomes and complications associated with hip fractures in patients with RA relative to those without RA.

Methods: Using the Japanese National Administrative Diagnosis Procedure Combination (DPC) database, we examined cases of femoral neck fractures from April 2016 to March 2023. After one to three propensity score matching for age, sex, and complications, we examined the association between RA, complications, and mortality during hospitalization in elderly patients with hip fractures.

Results: The findings revealed that elderly Japanese RA patients with hip fractures had significantly higher complications of pneumonia than elderly hip fracture patients without RA, with a ratio of 1.232 (95% CI: 1.065-1.426, p=0.0056), and pulmonary embolism, with a ratio of 1.155 (95% CI: 1.036-1.287, p=0.009) in multivariate logistic regression analyses. Although not significantly elevated, it also found a trend toward higher mortality during hospitalization, with a ratio of 1.179 (95% CI: 0.973-1.429, p=0.096).

Conclusions: A substantial study based on the Japanese DPC database revealed a significant association between RA and increased complications, including pneumonia and pulmonary embolism. On the other hand, there was a nonsignificant but higher trend for risk of mortality during hospitalization for hip fracture in elderly RA patients. Implementing preventive strategies is essential to minimizing complications in the treatment of hip fractures in patients with RA.

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来源期刊
Modern Rheumatology
Modern Rheumatology RHEUMATOLOGY-
CiteScore
4.90
自引率
9.10%
发文量
146
审稿时长
1.5 months
期刊介绍: Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions
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