Background/Purpose: While systemic rheumatic diseases, including Sjogren’s syndrome, systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and spondyloarthropathies, are known to have severe ophthalmologic manifestations, there is a lack of research addressing disparities in outcomes. The impact of these diseases on patients’ quality of life and healthcare costs, emphasizes the need to understand and address any disparities in optic complications.

Methods: This retrospective cross-sectional study utilized the Nationwide Inpatient Sample (NIS) database, the largest publicly available all-payer healthcare database in the United States that contains information on inpatient care, for the years of 2018 to 2021. This study focused on adult inpatients with RA, SLE and SpA, examining racial disparities in ocular complications such as keratitis, scleritis, episcleritis, retinopathy, choroidopathy, retinal vein/artery occlusion, vasculitis, and optic neuropathy. Logistic regression was employed to determine the influence of independent variables and covariates on the odds of ophthalmic complications. Additionally, odds of non-home discharge and mortality as well as length of stay and costs were assessed for subgroups with and without optic complications with logistic and linear regression models, respectfully. Age and sex matching (1:5 ratio) was performed.

Results: Black and Asian rheumatic disease patients were disproportionately hospitalized with optic complications compared to other racial groups. Patients with optic complications were also more frequently treated in large, urban teaching hospitals. Table 1). Additionally, optic complications were associated with adverse in-hospital outcomes, including longer hospital stays, higher total charges, and increased rates of non-home discharge (Figure 1). Multiple logistic regression models confirmed optic complications as an independent predictor of in-hospital mortality and non-home discharge (Table 2).

Conclusion: Optic complications in hospitalized patients with systemic rheumatic diseases are associated with worse in-hospital outcomes and higher healthcare utilization. disproportionately affecting Black and Asian patients. Addressing social and economic factors contributing to these disparities and to improve access to eye care for vulnerable populations are crucial to improving patient outcomes and reducing the burden of these complications.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/racial-disparities-in-ocular-complications-of-systemic-rheumatic-diseases-a-retrospective-cross-sectional-study/