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A population-based study of infection-related hospital mortality in patients with dermatomyositis/polymyositis

Sara G Murray1, Gabriela Schmajuk, Laura Trupin

  • 1University of California, San Francisco.

Arthritis Care & Research
|October 22, 2014
PubMed
Abstract

Insights

Infections are the leading cause of death for hospitalized patients with dermatomyositis (DM) and polymyositis (PM). Prompt infection management is crucial for improving outcomes in these inflammatory myopathies.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Dermatomyositis (DM) and polymyositis (PM) are inflammatory myopathies with high mortality rates.
  • The role of infection as a contributor to mortality in PM/DM patients requires further investigation.

Purpose of the Study:

  • To evaluate the contribution of infection to hospital mortality in a large population-based cohort of patients with DM/PM.
  • To compare infection prevalence and mortality in DM/PM hospitalizations with the general hospitalized population.

Main Methods:

  • Utilized Healthcare Cost and Utilization Project National Inpatient Samples data from 2007-2011.
  • Included hospital discharges meeting a validated administrative definition of DM/PM.
  • Employed logistic regression and calculated relative risks to analyze infection and mortality, adjusting for confounders.

Main Results:

  • 15,407 hospitalizations with DM/PM were analyzed; overall hospital mortality was 4.5%.
  • Infection was the strongest predictor of hospital mortality (OR 3.4), with bacterial (OR 3.5) and fungal infections (OR 2.5) independently associated with death.
  • Hospitalizations with DM/PM had a 1.5-fold increased burden of infection compared to the general hospitalized population.

Conclusions:

  • Infection is the primary driver of mortality among hospitalized patients with DM/PM.
  • Clinical and hospital-based strategies to reduce infection risk are essential for improving outcomes in DM/PM patients.

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