Mortality Due to Sepsis in Patients with Rheumatoid Arthritis

Orit Barrett¹, Ella Abramovich², Jacob Dreiher³, Victor Novack⁴ and Mahmoud Abu-Shakra⁵, ¹Department of Medicine D, Soroka Medical Center and Ben-Gurion University, Beersheba, Israel, ²Department of Medicine D, Soroka University Medical Center and Ben-Gurion University, Beersheba, Israel, ³Clalit Health Services, Ben-Gurion University of the Negev, Beer Sheva,,, BeerSheba, Israel, ⁴Clinical Research Center, Soroka Medical Center and Ben-Gurion University, Beersheba, Israel, ⁵Rheumatic Diseases Unit, Soroka Medical Center and Ben-Gurion University, Beer-Sheva, Israel

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Infection, morbidity and mortality and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 9, 2015

Title: Infection-related Rheumatic Disease: Poster Session

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Severe infections contribute significantly to the morbidity and mortality of patients with rheumatoid arthritis.

The aim of the study was to identify the characteristics of patients with RA who were admitted to intensive care unit (ICU) with Sepsis, to determine whether RA is an independent risk factors for short- and long-term mortality in patients admitted to the ICU with sepsis and to identify variables associated with mortality among patients with RA

Methods: The study was based on the data of SEPSIS-ISR, an ongoing prospective study that collects data on all patients admitted the ICUs with the diagnosis of sepsis. 124 patients with RA and sepsis were found in the database.

Controls: Age-and-gender matched controls who were admitted to the ICU with diagnosis of Sepsis were selected in a ratio of 2:1.

Results: The mean age of the patients with RA and control was 71 years with 65% of them were women. The main comorbidity included hypertension (77%), diabetes mellitus (57%), congestive heart failure (35%), renal failure (35%), and chronic lung disease (27%).

Severe sepsis and septic shock were diagnosed in 92% vs. 84% (P=0.032) and 50% vs. 39% (P=0.059) in the RA patients and controls respectively. Pneumonia (35% vs. 30%) and urinary tract infection (9% vs. 15%) were the most common site of infection.

The 30 days mortality was 48% vs. 43% (P=0.37) in the RA and controls and the 3 years survival was 18% vs. 30% in the RA patients vs. controls (P=0.02).

In univariate analyses Variables associate with 3 years mortality included: RA (OR=2.2, P=0.009), CHF (OR=5.3 P=0.001), DM (OR=2.4 P=0.002), Charlson’s Score (OR=1.6 P=0.001), HTN (OR=1.86 P=0.036) and age (OR=1.03, P=0.017)

Multivariate analyses revealed that RA (OR=3.66 P=0.005) and Charlson’s score (OR=1.9 P=0.001) were the only variables associated with 3 years mortality

Conclusion: RA is an independent risk factor for adverse results in sepsis including sever sepsis, septic shock and 3 years mortality. Long term survival of patients with RA admitted to the ICU with sepsis is related to higher Charlson’s score. Other factors associated with higher mortality rates among patients with sepsis includes CHF, DM, HTN and advanced age.

Disclosure: O. Barrett, None; E. Abramovich, None; J. Dreiher, None; V. Novack, None; M. Abu-Shakra, None.

To cite this abstract in AMA style:

Barrett O, Abramovich E, Dreiher J, Novack V, Abu-Shakra M. Mortality Due to Sepsis in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/mortality-due-to-sepsis-in-patients-with-rheumatoid-arthritis/. Accessed .

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