In-hospital mortality rates for vasculitis have been declining over the past 2 decades, and to a greater extent than rates for non-vasculitis in-hospital mortality, a researcher reported.
Unadjusted in-hospital mortality in patients with a primary diagnosis of vasculitis declined by 43% from 32.8/1,000 in 1998 to 18.7/1,000 in 2014 (P
“Mortality in vasculitis remains a concern, as this is a systemic autoimmune disease. Because few studies have examined national trends in U.S. mortality, our objective was to assess time trends for in-hospital mortality in vasculitis and compare them with rates in the general population, using the U.S. National Inpatient Sample, which is a 20% stratified sample of all hospital discharges in the U.S.,” Singh stated at a poster session at the American College of Rheumatology virtual meeting.
During the years 1998 to 2014 there were 266,461 primary vasculitis hospitalizations, with 7,215 deaths (2.7%). Patients’ mean age was 42.9 years, 57% were men, and 50% were white. Deyo-Charlson comorbidity scores of 2 or higher were seen in 30% and Medicaid was the insurance payer for 18%.
Age- and sex-adjusted mortality rates declined over the study period for both vasculitis and non-vasculitis patients. Among those with vasculitis, the age- and sex-adjusted mortality rate fell from 27.3/1,000 claims in 1998 to 19.1/1,000 claims in 2014, which represented a 30% reduction. For non-vasculitis patients, the adjusted rates decreased from 15.1/1,000 to 13.2/1,000, which was a 12.6% reduction (P
The gap in in-hospital mortality rates between vasculitis and non-vasculitis narrowed, with a vasculitis to non-vasculitis in-hospital mortality ratio of 1.81 during the years 1998-2000 and 1.45 in 2013-2014.
Yet the rate of primary vasculitis hospitalizations remained fairly constant from 1998 to 2014, at approximately 14,000 to 18,000 per year, with rates of 43 per 100,000 inpatient sample claims in 1998-2000 and 43.2 per 100,000 in 2013-2014 — 0.05% of claims per year.
“However, despite the reduction in the gap between vasculitis and non-vasculitis in-hospital mortality rates, there still remained a small gap in the age- and sex-adjusted mortality rates, meaning that additional interventions could help further reduce this gap,” Singh said.
Study limitations included the potential for misclassification bias and a lack of medication and laboratory data.
Singh disclosed relevant relationships with Crealta/Horizon, Medisys, Fidia, UBM, Trio, Clearview Healthcare Partners, Putnam Associated, Focus Forward, Navigant, Spherix, Amarin, Viking, the NIH, and the American College of Rheumatology.
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