Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis.

IF 2.3 Q2 RHEUMATOLOGY International Journal of Rheumatology Pub Date : 2017-01-01 Epub Date: 2017-10-18 DOI:10.1155/2017/6730812

Atsushi Hashimoto, Shiori Suto, Kouichiro Horie, Hidefumi Fukuda, Shinichi Nogi, Kanako Iwata, Hirotaka Tsuno, Hideki Ogihara, Misato Kawakami, Akiko Komiya, Hiroshi Furukawa, Toshihiro Matsui, Shigeto Tohma

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引用次数: 23

Abstract

Objective: Rheumatoid arthritis (RA) may be complicated by different infections, but risk factors for these are not fully elucidated. Here, we assessed the incidence of and risk factors for infections requiring hospitalization (IRH) including pneumocystis pneumonia (PCP) in patients with RA.

Methods: We retrospectively surveyed all RA patients treated at our hospital from 2009 to 2013, for whom data were available on demographic features, medications, comorbidities, and severity of RA. Multivariate logistic regression analysis was applied to calculate adjusted odds ratios (ORs) for factors associated with the occurrence of IRH.

Results: In a total of 9210 patient-years (2688 patients), there were 373 IRH (3.7/100 patient-years). Respiratory tract infections were most frequent (n = 154, and additionally 16 PCP), followed by urinary tract infections (n = 50). Significant factors for PCP included higher age (≥70 years; OR 3.5), male sex (6.6), underlying lung disease (3.0), use of corticosteroids (4.8), and use of biologics (5.4). Use of methotrexate (5.7) was positively associated with PCP but negatively with total infections (0.7). Additionally, functional disorders and higher RA disease activity were also related to total infections.

Conclusions: Risk factors for infection should be taken into account when deciding treatment for the individual RA patient.

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日本类风湿关节炎患者中需要住院治疗的感染的发生率和危险因素，包括肺囊虫肺炎

目的:类风湿关节炎(RA)可能并发不同的感染，但这些感染的危险因素尚未完全阐明。在这里，我们评估了类风湿关节炎患者需要住院的感染(IRH)的发生率和危险因素，包括肺囊虫性肺炎(PCP)。方法:我们回顾性调查了2009年至2013年在我院治疗的所有RA患者，这些患者的人口统计学特征、药物、合并症和RA的严重程度。应用多因素logistic回归分析计算与IRH发生相关因素的校正优势比(ORs)。结果:9210患者-年(2688例)中，IRH发生373例(3.7/100患者-年)。呼吸道感染最常见(n = 154，另外16 PCP)，其次是尿路感染(n = 50)。PCP的显著因素包括年龄较大(≥70岁;OR 3.5)、男性(6.6)、潜在肺部疾病(3.0)、使用皮质类固醇(4.8)和使用生物制剂(5.4)。甲氨蝶呤的使用与PCP呈正相关(5.7)，但与总感染呈负相关(0.7)。此外，功能障碍和较高的RA疾病活动性也与总感染有关。结论:在决定对单个RA患者的治疗时，应考虑感染的危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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