TY - JOUR
T1 - Population-based study of outcomes of patients with juvenile idiopathic arthritis (JIA) compared to non-JIA subjects
AU - Krause, Megan L.
AU - Zamora-Legoff, Jorge A.
AU - Crowson, Cynthia S.
AU - Muskardin, Theresa Wampler
AU - Mason, Thomas
AU - Matteson, Eric L.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objective Evaluate healthcare utilization and occurrence of comorbidities in a population-based cohort of patients of juvenile idiopathic arthritis (JIA) with an age- and sex-matched comparator group. Methods Prevalent cases of JIA in 1994–2013 were identified in Olmsted County, Minnesota, along with age- and sex-matched non-JIA comparators. Surgeries, hospitalizations, pregnancies, and comorbidities were identified by medical record review. Poisson methods were used to generate rate ratios (RR) with 95% confidence intervals (CI) to compare outcomes between JIA and non-JIA cohorts separately during childhood (age < 18 years) and adulthood (age ≥ 18 years). Results A total of 89 JIA and 89 non-JIA comparators were identified [64% female; mean (SD) age 8.6 (5.1) years at JIA incidence/index date and mean follow-up in childhood 6.3 (4.4) years for JIA; similar for comparators]. Among them, 38 pairs had follow-up into adulthood with mean follow-up of 8.0 (5.5) years for JIA. Children with JIA were more likely to have joint surgery (RR = 3.93, 95% CI: 1.18–24.94), non-joint surgery (RR = 1.90, 95% CI: 1.05–3.67), and hospitalizations (RR = 2.25, 95% CI: 1.04–5.53) than non-JIA comparators. As adults only joint surgeries remained significantly different (RR = 8.5, 95% CI: 2.27–120.1). Depression during childhood was more common in JIA (RR = 2.49, 95% CI: 1.01–6.13). There were no differences in educational achievement, employment status, or pregnancy outcomes between the 2 groups. Conclusions In a population-based cohort, inpatient healthcare utilization is higher for patients with JIA including surgery and hospitalization during childhood but not extending into adulthood. Understanding long-term comorbidities and healthcare needs for patients with JIA is necessary to provide comprehensive care.
AB - Objective Evaluate healthcare utilization and occurrence of comorbidities in a population-based cohort of patients of juvenile idiopathic arthritis (JIA) with an age- and sex-matched comparator group. Methods Prevalent cases of JIA in 1994–2013 were identified in Olmsted County, Minnesota, along with age- and sex-matched non-JIA comparators. Surgeries, hospitalizations, pregnancies, and comorbidities were identified by medical record review. Poisson methods were used to generate rate ratios (RR) with 95% confidence intervals (CI) to compare outcomes between JIA and non-JIA cohorts separately during childhood (age < 18 years) and adulthood (age ≥ 18 years). Results A total of 89 JIA and 89 non-JIA comparators were identified [64% female; mean (SD) age 8.6 (5.1) years at JIA incidence/index date and mean follow-up in childhood 6.3 (4.4) years for JIA; similar for comparators]. Among them, 38 pairs had follow-up into adulthood with mean follow-up of 8.0 (5.5) years for JIA. Children with JIA were more likely to have joint surgery (RR = 3.93, 95% CI: 1.18–24.94), non-joint surgery (RR = 1.90, 95% CI: 1.05–3.67), and hospitalizations (RR = 2.25, 95% CI: 1.04–5.53) than non-JIA comparators. As adults only joint surgeries remained significantly different (RR = 8.5, 95% CI: 2.27–120.1). Depression during childhood was more common in JIA (RR = 2.49, 95% CI: 1.01–6.13). There were no differences in educational achievement, employment status, or pregnancy outcomes between the 2 groups. Conclusions In a population-based cohort, inpatient healthcare utilization is higher for patients with JIA including surgery and hospitalization during childhood but not extending into adulthood. Understanding long-term comorbidities and healthcare needs for patients with JIA is necessary to provide comprehensive care.
KW - Depression
KW - Healthcare utilization
KW - Juvenile idiopathic arthritis
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U2 - 10.1016/j.semarthrit.2016.07.003
DO - 10.1016/j.semarthrit.2016.07.003
M3 - Article
C2 - 27522464
AN - SCOPUS:84994242450
SN - 0049-0172
VL - 46
SP - 439
EP - 443
JO - Seminars in Arthritis and Rheumatism
JF - Seminars in Arthritis and Rheumatism
IS - 4
ER -