Stroke: RA shows no effect on inpatient outcomes, mortality

  • Kang JH & al.
  • Clin Rheumatol
  • 12 Sep 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Patients with rheumatoid arthritis (RA) who are hospitalized for stroke have no difference in adverse outcomes, including in-hospital mortality, vs other hospitalized patients with stroke who do not have RA.
  • The only exceptions were that patients with RA had higher risk for peptic ulcer and mechanical ventilation use for 1 stroke subtype.

Why this matters

  • No extra precautions are needed for patients with RA during hospitalization for stroke.

Study design

  • Cross-sectional cohort of 27,142 patients hospitalized for stroke in the Taiwan Longitudinal Health Insurance Database, 2005.
  • 764 patients with stroke in the cohort with a prior diagnosis of RA were compared with 2292 age- and sex-matched patients with stroke without RA.
  • Primary outcome was in-hospital mortality.
  • Funding: None disclosed.

Key results

  • No difference between groups in the following adverse outcomes:
    • in-hospital mortality,
    • pneumonia,
    • urinary tract infection,
    • acute respiratory failure,
    • use of mechanical ventilation, and
    • length of stay.
  • The RA group had higher risks than the non-RA group of these adverse outcomes:
    • peptic ulcer (OR, 1.52; 95% CI, 1.05-2.20) and
    • use of mechanical ventilation for subarachnoid/intracerebral hemorrhagic stroke (OR, 1.89; 95% CI, 1.14-3.15).

Limitations

  • Observational design.
  • RA disease severity unknown.
  • Behavioral risk factors (e.g., BMI) unknown.
  • Outcomes after hospitalization unknown.

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