Hospitalizations for Rheumatoid Arthritis Have Decreased

Newswise — Hospitalization rates for three severe complications related to rheumatoid arthritis have decreased over the past 19 years, which is an indicator that the outcomes associated with having the disease are improving, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Orlando, Florida.

Hospital discharge records of all patients treated in acute care hospitals in California from 1983 to 2001 were searched for hospitalizations of patients age 40 and older with a diagnosis of one of four manifestations of severe rheumatoid arthritis: vasculitis (inflammation of the blood vessels); splenectomy in patients with Felty's syndrome (the removal of the spleen from those with a disorder characterized by rheumatoid arthritis, an enlarged spleen, a decreased white blood cell count, and recurrent infection); cervical spine surgery in patients with myelopathy (disturbance or disease of the spinal cord); and total knee arthroplasty (joint replacement surgery). Rates of hospitalizations for each diagnosis or procedure were calculated using annual estimates of the number of people with rheumatoid arthritis living in California. Over the 19-year study period, the analysis showed that hospital rates for vasculitis and splenectomy decreased progressively over time, but that there were no significant decreases in rates of hospitalizations for cervical spine surgery in myelopathy or total knee arthroplasty. Considering only first-time knee replacements, for which data were available from 1990 to 2001, rates decreased 10%, with a reversal in recent years of the trend toward increased knee replacements after a peak in 1997.

"Over the past few years, we have learned that the more aggressive treatment approach now used to treat rheumatoid arthritis has resulted in improvements in the symptoms and functioning of patients," said Michael M. Ward, MD, Investigator, NIAMS/National Institutes of Health, Bethesda, Maryland, and the investigator in the study. "These results show improvements in the long-term outcomes of rheumatoid arthritis, and indicate that our treatment approach is on the right track."

The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal diseases. For more information on the ACR's annual meeting, see http://www.rheumatology.org/annual.