Racial/Ethnic variations in morbidity and mortality in Adult Onset Still's Disease: An analysis of national dataset.
Publication/Presentation Date
12-1-2019
Abstract
OBJECTIVES: Adult Onset Still's Disease (AOSD) is a rare autoinflammatory disorder. There is relatively little known about the impact of social determinants of health on its outcomes. Our goal is to describe the racial/ethnic variations, morbidity and mortality of AOSD hospitalized patients in the US.
MATERIALS AND METHODS: Adult US hospitalized patients between 2009-13 from a nationwide inpatient sample (NIS) database with AOSD were identified using ICD-9 code 714.2. NIS is the largest all-payer US inpatient database with approximately 8 million hospitalizations yearly. Patients with other autoimmune diseases were excluded. We used descriptive statistics to summarize patient and hospital characteristics. We performed survey-weighted logistic regression models adjusting for confounders to study our primary outcome: in-hospital mortality.
RESULTS: Between 2009-13, 5,820 AOSD patients were hospitalized with a mean age of 53.6 (SE-0.61) years. 3817 (65.6%) were female, 56% white and 3% Asian. Macrophage Activating Syndrome (1.7%), Disseminated Intravascular Coagulation (DIC-1.1%) and Thrombotic Thrombocytopenic Purpura (0.4%), respectively, complicated the hospital course. There were 154 inpatient deaths in study period (mortality 2.6%). Mean age of patients who died in hospital was higher (62.4 years ± 3.1) and 13.9% were Asians. Patients of Asian origin had significantly higher odds of in-hospital death compared to whites (aOR = 6.39, 95% CI 1.77-23.1, p = 0.005). Mortality was significantly higher for patients whose hospital course was complicated by DIC (aOR = 29.69, 95% CI 5.5-160.41, p = 0.006).
CONCLUSIONS: In this national sample of patients hospitalized for AOSD, we found significant variations in In-hospital mortality.
Volume
49
Issue
3
First Page
469
Last Page
473
ISSN
1532-866X
Published In/Presented At
Mehta, B. Y., Ibrahim, S., Briggs, W., & Efthimiou, P. (2019). Racial/Ethnic variations in morbidity and mortality in Adult Onset Still's Disease: An analysis of national dataset. Seminars in arthritis and rheumatism, 49(3), 469–473. https://doi.org/10.1016/j.semarthrit.2019.04.004
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
31109638
Department(s)
Administration and Leadership
Document Type
Article