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Research ArticleAccepted Article

Hospitalized Infections in People with Osteoarthritis: A National U.S. Study

Jasvinder A. Singh and John D. Cleveland
The Journal of Rheumatology August 2020, jrheum.191383; DOI: https://doi.org/10.3899/jrheum.191383
Jasvinder A. Singh
From the Medicine Service, VA Medical Center, 510, 20th street South, FOT 805B, Birmingham, AL 35233, USA; Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, 1720 Second Ave South, Birmingham, AL 35294-0022, USA. Address correspondence to Jasvinder A. Singh, MBBS, MPH, University of Alabama at Birmingham, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL 35294-0022. E-mail: Jasvinder.md@gmail.com
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John D. Cleveland
From the Medicine Service, VA Medical Center, 510, 20th street South, FOT 805B, Birmingham, AL 35233, USA; Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, 1720 Second Ave South, Birmingham, AL 35294-0022, USA. Address correspondence to Jasvinder A. Singh, MBBS, MPH, University of Alabama at Birmingham, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL 35294-0022. E-mail: Jasvinder.md@gmail.com
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Abstract

Objective To study the incidence, time-trends and outcomes of serious infections in people with osteoarthritis.

Methods We used the 1998-2016 U.S. National Inpatient Sample data. We examined the epidemiology of five hospitalized, i.e., serious infections (opportunistic infections (OI), skin and soft tissue infections (SSTI), urinary tract infection (UTI), pneumonia, and sepsis/bacteremia) in people with osteoarthritis, using recommended weights. We performed multivariable-adjusted logistic regression analyses to analyze factors associated with healthcare utilization (hospital charges, length of hospital stay, discharge to non-home setting), and in-hospital mortality.

Results Of all serious infection hospitalizations, 46,708,154 were without osteoarthritis, and 3,258,416 had osteoarthritis. Respectively, people with OA were 16 years older, more likely to be female (52% vs. 65%), White (59% vs. 70%), have Deyo-Charlson index score ≥2 (41% vs 51%), Medicare (54% vs. 80%), and less likely to receive care at an urban teaching hospital (45% vs. 39%). Serious infection rates /100,000 NIS hospitalizations increased from 1998-2000 to 2015-2016: OI from 4.5 to 7.2; SSTI, 48.3 to 145.8; UTI, 8.4 to 104.6; pneumonia, 164.0 to 224.3; sepsis, 39.4 to 436.3. In multivariable-adjusted analyses, older age, higher Deyo-Charlson score, sepsis, Northeast region, urban hospital and medium or large hospital bed size were significantly associated with higher healthcare utilization outcomes and inhospital mortality; and Medicaid insurance, non-White race, and female sex with higher healthcare utilization.

Conclusion Serious infection rates have increased in people with osteoarthritis. Association of demographic, clinic and hospital variables with serious infection outcomes identifies potential targets for future interventions.

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The Journal of Rheumatology
Vol. 48, Issue 1
1 Jan 2021
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Accepted manuscript
Hospitalized Infections in People with Osteoarthritis: A National U.S. Study
Jasvinder A. Singh, John D. Cleveland
The Journal of Rheumatology Aug 2020, jrheum.191383; DOI: 10.3899/jrheum.191383

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Accepted manuscript
Hospitalized Infections in People with Osteoarthritis: A National U.S. Study
Jasvinder A. Singh, John D. Cleveland
The Journal of Rheumatology Aug 2020, jrheum.191383; DOI: 10.3899/jrheum.191383
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