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Serious infections in people with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA): a time-trend national

Jasvinder A Singh1,2,3, John D Cleveland4

  • 1Medicine Service, VA Medical Center, 510, 20th street South, FOT 805B, Birmingham, AL, 35233, USA. Jasvinder.md@gmail.com.

Clinical Rheumatology
|May 14, 2020
PubMed
Abstract

Insights

Serious infections, particularly sepsis, are increasingly common in polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) patients. These infections are linked to higher healthcare use and mortality, necessitating targeted interventions.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Epidemiology

Background:

  • Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are inflammatory conditions associated with increased infection risk.
  • Understanding the trends and outcomes of serious infections in these patient groups is crucial for clinical management.

Purpose of the Study:

  • To determine the incidence, temporal trends, and outcomes of serious infections in patients diagnosed with PMR or GCA.
  • To identify risk factors associated with healthcare utilization and mortality in PMR/GCA patients experiencing serious infections.

Main Methods:

  • Analysis of the US National Inpatient Sample (1998-2016) to identify serious infections (opportunistic infections, skin and soft tissue infections, urinary tract infections, pneumonia, sepsis/bacteremia) in PMR/GCA patients.
  • Multivariable-adjusted logistic regression models were used to assess associations between infection type, patient demographics, comorbidities, hospital characteristics, and clinical outcomes.

Main Results:

  • Patients with PMR or GCA hospitalized for serious infections were significantly older, more likely female, white, and had higher comorbidity scores and income compared to controls.
  • Sepsis incidence increased over time, surpassing pneumonia as the most common serious infection in PMR/GCA cohorts by 2011-2012.
  • In PMR and GCA cohorts, sepsis, female sex, higher comorbidity scores, Medicare/Medicaid insurance, and urban hospital location were associated with increased healthcare utilization and/or in-hospital mortality.

Conclusions:

  • The incidence of serious infections, especially sepsis, has risen in patients with PMR and GCA.
  • These findings highlight the need for interventions to improve outcomes for serious infections in PMR and GCA patients.
  • Factors such as comorbidities and insurance status significantly impact healthcare utilization and mortality in this population.
Keywords:
EpidemiologyGCAGiant cell arteritisHealthcare utilizationMortalityOutcomesPMRPolymyalgia rheumaticaSerious infections

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