In Respiratory Failure, RA May Boost Mortality

SAN DIEGO — Much has been made of late of rheumatoid arthritis patients' substantially reduced life expectancy because of cardiovascular disease. Far less widely known is that they also have increased in-hospital mortality following acute respiratory failure.

In a study of 22,121 adults in the U.S. Nationwide Inpatient Sample database who had an emergency hospitalization for acute respiratory failure in 2003–2006, the 1,621 with comorbid rheumatoid arthritis or collagen vascular disease had an adjusted 21% increased risk of in-hospital mortality, Dr. David S. Kountz said at the annual meeting of the American College of Chest Physicians.

Unadjusted in-hospital mortality rates were 24.9% in the rheumatologic group and 24.3% in the 20,500 patients without such comorbidity. But the rheumatoid arthritis/collagen vascular disease group was younger, wealthier, and far more likely to be female.

After adjustment for these and other potential confounders, such as hospital teaching status, in a multivariate logistic regression analysis, the rheumatologic group had significantly greater in-hospital mortality, according to Dr. Kountz of Jersey Shore University Medical Center, Neptune, N.J.

Disclosures: Dr. Kountz reported having no relevant conflicts of interest.