ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1662

Unrecognised, Subclinical, Structural or Functional Lung Changes in Rheumatoid Arthritis Is Associated with a Higher Risk of Developing Serious Respiratory Tract Infection

Benjamin Worcester1, Dorothy Wang2, Susan Morton3 and Michelle Leech4, 1Monash Health, Melbourne, Australia, 2Melbourne Health, Clayton, Australia, 3Monash Health, Clayton, Australia, 4Monash Medical Centre, Australia, Australia

Meeting: ACR Convergence 2021

Keywords: Infection, pulmonary, rheumatoid arthritis, risk assessment, risk factors

  • Tweet
  • Email
  • Print
Session Information

Date: Tuesday, November 9, 2021

Session Title: RA – Diagnosis, Manifestations, & Outcomes Poster IV: Outcomes, Trajectory of Disease, & Epidemiology (1645–1673)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: The incidence of lung disease within the rheumatoid arthritis is well described and likely underestimated. Additionally, RA patients are at higher risk for developing significant infections (SI).

In our own cohort the most common infections recorded were respiratory tract infections (RTI) and this was most likely to lead to increased mortality. This accords with studies showing that hospitalisations from pneumonia are higher in RA cohort compared to matched cohorts.

To determine if pre-existing subclinical functional or structural lung disease had an association with an increased risk of respiratory tract infections, including viral pneumonias, as opposed to other infections.

Methods: All patients in our tertiary hospital RA cohort, in the last 3 years, who had any SI were included. The patient’s medical history was examined to determine if they had evidence of functional or structural lung damage prior to the infection using imaging records and previous pulmonary function tests. Patients presenting to hospital, or their general practitioner, and their diagnosis on discharge was either community acquired pneumonia, viral respiratory tract infection or other lower respiratory tract infection were included. Patients with RTI were compared to a sample of patients with RA and any non-respiratory SI (Table 1).

A Chi-Square analysis was used to compare the groups. The two groups were matched for daily steroid use, smoking history and vaccination status, there was no statistical difference between these two groups.

Results: 142 patients were identified as having an SI in the past 3 years in our cohort. 48 patients developed RTI and 94 patients who developed other infections including Urinary traction infections, skin and soft tissue infections. Of the 48 who developed RTI, 32 had evidence of subclinical lung disease compared to 16 with no evidence of lung disease. Of the 94 who developed other SI, only 21 had evidence of subclinical lung disease compared to 73 with no evidence of subclinical lung disease (Table 2).

A Chi-Square analysis of the data was performed

X2 = (1, N = 142) = 23.84, p < 0.001

allowing us to consider that pre-existing lung disease may be involved in this subset of RA patients being more susceptible to LRTIs. Patients with known pre-existing lung disease where excluded from this analysis.

Conclusion: A greater number of patients within the RTI group had previous lung abnormality compared to patients in the non-pulmonary infection group. This supports evolving literature that even subclinical lung abnormality should be considered within the suite of risk factors for RTI risk in RA.

Given the current climate and fear surround viral pneumonias, screening this cohort will allow for better risk stratification and management of these patients. This may include early admission and intervention or, in the outpatient setting, highlight the need for discussion around vaccinations to reduce this risk.

Table 1: Patient demographics and selected investigations (n =142)

Table 2: Type of infections suffered and evidence of subclinical lung disease (n = 142)


Disclosures: B. Worcester, None; D. Wang, None; S. Morton, None; M. Leech, None.

To cite this abstract in AMA style:

Worcester B, Wang D, Morton S, Leech M. Unrecognised, Subclinical, Structural or Functional Lung Changes in Rheumatoid Arthritis Is Associated with a Higher Risk of Developing Serious Respiratory Tract Infection [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/unrecognised-subclinical-structural-or-functional-lung-changes-in-rheumatoid-arthritis-is-associated-with-a-higher-risk-of-developing-serious-respiratory-tract-infection/. Accessed January 28, 2023.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/unrecognised-subclinical-structural-or-functional-lung-changes-in-rheumatoid-arthritis-is-associated-with-a-higher-risk-of-developing-serious-respiratory-tract-infection/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences