One-third of patients hospitalized for GCA require readmission within 6 months
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Patients with giant cell arteritis may require unexpected and sudden care, with as many as one-third requiring readmission to a health care center within 6 months of an episode, according to data published in Arthritis Care & Research.
“There is limited information on the outcomes of patients hospitalized with GCA,” Radjiv Goulabchand, MD, PhD, of the University of Montpelier, in France, and colleagues wrote. “Identifying characteristics of patients at high risk for frequent hospitalizations, and long hospital stays, could help to tailor those risks and reduce health care costs in these elderly patients.”
To investigate burden, risk factors and outcomes among patients with GCA, Goulabchand and colleagues collected and analyzed data from the 2017 U.S. National Readmission Database. The researchers identified patients aged 50 years or older who were hospitalized with at least one code of GCA as a primary or secondary diagnosis at the time of discharge. Patients were excluded if their index date was closer than 6 months from the end of the study period, if patients were transferred from other hospital systems, if they were missing data for significant periods of time or if they were diagnosed with other autoimmune diseases.
For this study, the “at-risk” period spanned from the time of the incident hospital admission until Dec. 31, 2017, or death. The researchers extracted data including age, sex, primary payment source, income quartile and any important comorbidities. Main outcomes included the risk for readmission at 1, 3 and 6 months following the index hospitalization date, the annual burden and cost of hospitalization, and the percentage of patients who died while in the hospital. The researchers classified all causes of hospital readmission for patients readmitted within 6 months.
The analysis included 1,206 patients hospitalized for GCA. Of those patients, 13% experienced ophthalmic complications at the time of index hospitalization. According to the researchers, 3% of patients died during the study period and 34% of patients were readmitted to the hospital within 6 months of the index hospitalization. The most common reasons for readmission included infections and cardiovascular disease. Smoking and obesity were the factors most strongly associated with readmission.
“In this nationally representative study of patients hospitalized with GCA, we observed high rates of unplanned health care utilization and considerable variability in burden of hospitalization, with a small fraction of patients contributing disproportionately to total hospitalization burden and costs,” Goulabchand and colleagues wrote. “Infections and cardiovascular diseases, potentially related to prolonged corticosteroid exposure, contribute as leading causes of readmission.”
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