Rheumatoid Arthritis Associated Asthma Exacerbations: A National Inpatient Sample 2016- 2020
Recommended Citation
Alwarawrah Z, El Sharu H, Parekh V, Singh S, Hammami S, Bishnoi A. Rheumatoid Arthritis Associated Asthma Exacerbations: A National Inpatient Sample 2016- 2020. Am J Respir Crit Care Med 2024; 209.
Document Type
Conference Proceeding
Publication Date
5-21-2024
Publication Title
Am J Respir Crit Care Med
Abstract
Introduction: Population-based studies have determined a higher likelihood of developing Asthma in patients with Rheumatoid Arthritis (RA). Conversely, there is a higher likelihood of developing RA in patients with Asthma. (1,2,3). We aimed to analyze the prevalence of Asthma Exacerbations (AE) in patients admitted to the hospital with RA compared to asthma patients without RA. Methods: The 2016 - 2020 National Inpatient Sample Database (NIS) was analyzed using the International Classification of Diseases - 10 Clinical Modification codes to identify adult hospitalizations with RA. The study's primary outcome was to assess the prevalence of AE in patients with RA compared to patients without RA. Multivariate logistic regression and linear regression analyses were used to adjust for possible confounders. Results: Out of 782,224 hospitalized with AE, 19,346 (0.012%) had RA. Of these, (91.9%) were females. The mean age of patients with RA hospitalized with AE was 58.6 compared to 32.5 in patients without RA (p Value <0.001). Moreover, patients with AE and RA had longer lengths of stay and total hospital charges compared to patients without RA, 3.9 days vs. 2.7 days (p-Value <0.001) and 37091 vs. 27610 (p-Value <0.001), respectively. Logistic regression analysis showed that patients with RA had a higher risk of hospitalization with an Asthma Exacerbation than the general population (adjusted Odds Ratio [aOR] of 1.09, 95% Confidence Interval [CI] 1.04 - 1.14). Notably, patients with RA and Asthma Exacerbations had a higher risk of Obstructive Sleep Apnea (aOR: 2.38, CI: 2.11 - 2.68), Obesity (aOR: 1.58, CI: 1.43 - 1.75), and Upper Respiratory Tract Infections (aOR: 6.77, CI: 5.68 - 8.06). Patients with RA and Asthma Exacerbations had a lower risk of Heart Failure Exacerbation (aOR: 0.32, CI: 0.23 - 0.43), Tobacco Use Disorder (aOR: 0.28, CI: 0.11 - 0.67), and chronic kidney disease (aOR: 0.45, CI: 0.37 - 0.57). There was no statistically significant difference in ischemic stroke (aOR: 0.14, CI: 0.02 - 1.01) or COPD (aOR: 0.90, CI: 0.60 - 1.35). Conclusion: Patients with RA were more likely to have asthma exacerbations than the general population, but the observed effect is likely not clinically significant. Females with RA were more likely to be hospitalized with asthma exacerbations. Patients with RA and Asthma Exacerbations had a higher risk of Obstructive Sleep Apnea, Obesity, and Upper Respiratory Tract Infections. They had lower odds of Heart Failure Exacerbations, Tobacco Use Disorder, Hemodialysis, and chronic kidney disease.
Volume
209
