Temporal Trends in Mortality in Patients Hospitalized for Cerebrovascular Events with Psoriatic Arthritis: Data from the Healthcare Cost and Utilization Project from 2010-2014

Shraddha Jatwani¹, Karan Chugh², Karan Jatwani³, Stuthi Perimbeti⁴, Vivek Modi⁵, Jasleen Kaur⁶ and Rakesh K Sharma⁷, ¹Department of Internal Medicine, Division of Rheumatology, Henry Ford Allegiance Health, Jackson, MI, ²Division of Pulmonary, Critical Care & Sleep, Wayne State University/Detroit Medical Center, Detroit, MI, ³Department of Internal Medicine, Mount Sinai West - St Luke’s Hospital, New York, NY, ⁴Department of Internal Medicine, Mount Sinai West - St Luke’s Hospital,, NEW YORK, NY, ⁵Department of Internal Medicine, Mount Sinai West - St Luke’s Hospital,, New York, NY, ⁶Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI, ⁷Department of Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Cerebrovascular disease, Morbidity and mortality and psoriatic arthritis

Session Information

Date: Tuesday, October 23, 2018

Title: Epidemiology and Public Health Poster III: SLE, SSc, APS, PsA, and Other Rheumatic Diseases

Session Type: ACR Poster Session C

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

Background/Purpose:

Cerebrovascular disease risk in increased in patients of Psoriatic arthritis (PsA), as reported in the literature. Epidemiological studies to assesses average annual trends are not available in current literature. Majority of studies are from single centers. Our objectives were to describe the demographics and trends of outcomes for PsA patients admitted with cerebrovascular events in United States.

Methods:

We analyzed data from the Healthcare Cost and Utilization Project’s (HCUP) National Inpatient Sample (NIS). All hospitalized adult (>18 years) patients between 2010 and 2014 hospitalized for cerebrovascular event (stroke or transient ischemic attack) from NIS database were captured, and stratified into two groups based on secondary diagnosis of PsA, using ICD9 codes. Stata version 15 (College Station, TX) was used to perform the statistical analysis. We analyzed the trends in hospitalization, length of stay, total cost per admission and mortality for cerebrovascular events. Chi-Square test, linear regression and multivariate regression models were used for analysis.

Results:

Between 2010 and 2014, 2,255,127 were hospitalized with cerebrovascular events including acute stroke and transient ischemic attack (TIA). 1583 patients were found to have a secondary diagnosis of PsA. Patients admitted with cerebrovascular events and underlying PSA had a mean age of 67.5 ±0.71 years, which was significantly lower in comparison to general population where mean age was 70.86 ±0.08 years (p value = 0.00). 50.49% patients were females in patients with PsA. There was no significant difference in rates of overall mortality between the two groups from 2010-2014 (2.99% for patients without PsA and 2.71% for patients with PsA, p value=0.769), and this trend was noted in mortality rates from each year (2010 to 2014).

Conclusion:

Patients with PsA were admitted with cerebrovascular events at a younger age compared to their counterparts, suggesting higher burden of comorbidities and inflammation. Compared to previously reported data, there wasn’t a significance difference in cerebrovascular mortality in patients with PsA. Decreased risk of mortality possibly reflects early recognition and treatment of PsA, with increased awareness of PsA as well as associated cardiovascular risk. Providers should continue to screen patients with PsA for risk factors associated with cardiovascular and cerebrovascular morbidity and mortality, to improve healthcare outcomes.

Disclosure: S. Jatwani, None; K. Chugh, None; K. Jatwani, None; S. Perimbeti, None; V. Modi, None; J. Kaur, None; R. K. Sharma, None.

To cite this abstract in AMA style:

Jatwani S, Chugh K, Jatwani K, Perimbeti S, Modi V, Kaur J, Sharma RK. Temporal Trends in Mortality in Patients Hospitalized for Cerebrovascular Events with Psoriatic Arthritis: Data from the Healthcare Cost and Utilization Project from 2010-2014 [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/temporal-trends-in-mortality-in-patients-hospitalized-for-cerebrovascular-events-with-psoriatic-arthritis-data-from-the-healthcare-cost-and-utilization-project-from-2010-2014/. Accessed .

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