Inpatient complications in patients with giant cell arteritis: decreased mortality and increased risk of thromboembolism, delirium and adrenal insufficiency.

Autor:	Unizony, Sebastian, Menendez, Mariano E., Rastalsky, Naina, Stone, John H.
Předmět:	THROMBOEMBOLISM risk factors RISK of delirium ADRENAL insufficiency ACADEMIC medical centers CONFIDENCE intervals STATISTICAL correlation DATABASES GIANT cell arteritis MEDICAL information storage & retrieval systems MORTALITY MULTIVARIATE analysis REGRESSION analysis STATISTICS T-test (Statistics) LOGISTIC regression analysis DATA analysis RELATIVE medical risk CROSS-sectional method DATA analysis software DESCRIPTIVE statistics ODDS ratio DISEASE complications DISEASE risk factors
Zdroj:	Rheumatology; Aug2015, Vol. 54 Issue 8, p1360-1368, 9p, 1 Diagram, 3 Charts, 1 Graph
Abstrakt:	Objective: The morbidity and mortality of hospitalized GCA patients have been unexplored. The aim of this study was to analyse inpatient complications experienced by patients with GCA. Methods: We used the Nationwide Inpatient Sample database to study a large group of patients admitted for pneumonia, myocardial infarction (MI), ischaemic stroke and femoral neck fracture. Patients were divided into two groups based on whether or not they had a diagnosis of GCA upon admission. Outcomes evaluated included inpatient mortality and the occurrence of adrenal insufficiency, deep vein thrombosis, pulmonary embolism and delirium. Results: From 2008 to 2011, 8203447 patients ≥50 years of age were discharged from US hospitals after admission with pneumonia, MI, stroke and femoral neck fracture. Among these patients, 9311 (0.11%) had GCA. Admissions for pneumonia, stroke and hip fracture were more frequent in GCA patients compared with those without GCA, accounting for 41.5% vs 39.4%, 24.9% vs 19.8% and 15.4% vs 14.2% of hospitalizations, respectively (P ≤ 0.001). Admissions for MI were more common in non-GCA patients (26.6% vs 18.2%, P< 0.001). During hospitalization, 4.1% of the GCA patients died, compared with 4.8% of those without GCA [odds ratio (OR) 0.73, P< 0.001). The GCA population suffered significantly more often from deep vein thrombosis (OR 2.08, P< 0.001), pulmonary embolism (OR 1.58, P< 0.001), delirium (OR 1.60, P< 0.001) and adrenal insufficiency (OR 4.95, P< 0.001). Conclusion: Hospitalized GCA patients have lower mortality compared with the general inpatient population but greater risk of venous thromboembolism, delirium and adrenal insufficiency. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
Externí odkaz:	Zobrazit plný text záznamu