Septic arthritis significantly increased the long-term mortality in geriatric patients

Chia Jung Wu, Chien Cheng Huang, Shih Feng Weng, Ping Jen Chen, Chien Chin Hsu, Jhi Joung Wang, How-Ran Guo, Hung Jung Lin

Research output: Contribution to journalArticle

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Abstract

Background: The elderly are predisposed to septic arthritis (SA) because of the aging nature and increasing comorbidities. SA may in turn increase the long-term mortality in the geriatric patients; however, it remains unclear. We conducted this prospective nationwide population-based cohort study to clarify this issue. Methods: Using Taiwan National Health Insurance Research Database (NHIRD), we identified 1667 geriatric participants (≥ 65 years) with SA and 16,670 geriatric participants without SA matched at a ratio of 1:10 by age, sex, and index date between 1999 and 2010. A comparison of the long-term mortality between the two cohorts through follow-up until 2011 was performed. Results: Geriatric participants with SA had a significantly increased mortality than those without SA [Adjusted hazard ratio (AHR): 1.49, 95% confidence interval (CI): 1.34-1.66], particularly the old elderly (≥ 85 years, AHR: 2.12, 95% CI: 1.58-2.84) and males (AHR: 1.54, 95% CI: 1.33-1.79). These results were stated after adjustment for osteoarthritis, diabetes, gout, renal disease, liver disease, cancer, rheumatoid arthritis, systemic lupus erythematosus, alcoholism, and human immunodeficiency virus infection. The increased mortality risk was highest in the first month (AHR: 3.93, 95% CI: 2.94-5.25) and remained increased even after following up for 2-4 years (AHR: 1.30, 95% CI: 1.03-1.65). After Cox proportional hazard regression analysis, SA (AHR: 1.37, 95% CI: 1.20-1.56), older age (≥ 85 years, AHR: 1.79, 95% CI: 1.59-2.02, 75-84 years, AHR: 1.65, 95% CI: 1.53-1.78), male sex, diabetes, renal disease, liver disease, cancer, and gout were independent mortality predictors. There was no significant difference in the mortality for SA between upper limb affected and lower limb affected. Conclusions: This study delineated that SA significantly increased the long-term mortality in geriatric participants. For the increasing aging population worldwide, strategies for the prevention and treatment of SA and concomitant control of comorbidities are very important.

Original languageEnglish
Article number178
JournalBMC geriatrics
Volume17
Issue number1
DOIs
Publication statusPublished - 2017 Aug 9

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Infectious Arthritis
Geriatrics
Mortality
Confidence Intervals
Gout
Liver Neoplasms
Comorbidity
Liver Diseases
Kidney
National Health Programs
Virus Diseases
Taiwan
Upper Extremity
Osteoarthritis
Systemic Lupus Erythematosus
Population
Alcoholism
Lower Extremity
Rheumatoid Arthritis
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

Cite this

Wu, C. J., Huang, C. C., Weng, S. F., Chen, P. J., Hsu, C. C., Wang, J. J., ... Lin, H. J. (2017). Septic arthritis significantly increased the long-term mortality in geriatric patients. BMC geriatrics, 17(1), [178]. https://doi.org/10.1186/s12877-017-0561-x
Wu, Chia Jung ; Huang, Chien Cheng ; Weng, Shih Feng ; Chen, Ping Jen ; Hsu, Chien Chin ; Wang, Jhi Joung ; Guo, How-Ran ; Lin, Hung Jung. / Septic arthritis significantly increased the long-term mortality in geriatric patients. In: BMC geriatrics. 2017 ; Vol. 17, No. 1.
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abstract = "Background: The elderly are predisposed to septic arthritis (SA) because of the aging nature and increasing comorbidities. SA may in turn increase the long-term mortality in the geriatric patients; however, it remains unclear. We conducted this prospective nationwide population-based cohort study to clarify this issue. Methods: Using Taiwan National Health Insurance Research Database (NHIRD), we identified 1667 geriatric participants (≥ 65 years) with SA and 16,670 geriatric participants without SA matched at a ratio of 1:10 by age, sex, and index date between 1999 and 2010. A comparison of the long-term mortality between the two cohorts through follow-up until 2011 was performed. Results: Geriatric participants with SA had a significantly increased mortality than those without SA [Adjusted hazard ratio (AHR): 1.49, 95{\%} confidence interval (CI): 1.34-1.66], particularly the old elderly (≥ 85 years, AHR: 2.12, 95{\%} CI: 1.58-2.84) and males (AHR: 1.54, 95{\%} CI: 1.33-1.79). These results were stated after adjustment for osteoarthritis, diabetes, gout, renal disease, liver disease, cancer, rheumatoid arthritis, systemic lupus erythematosus, alcoholism, and human immunodeficiency virus infection. The increased mortality risk was highest in the first month (AHR: 3.93, 95{\%} CI: 2.94-5.25) and remained increased even after following up for 2-4 years (AHR: 1.30, 95{\%} CI: 1.03-1.65). After Cox proportional hazard regression analysis, SA (AHR: 1.37, 95{\%} CI: 1.20-1.56), older age (≥ 85 years, AHR: 1.79, 95{\%} CI: 1.59-2.02, 75-84 years, AHR: 1.65, 95{\%} CI: 1.53-1.78), male sex, diabetes, renal disease, liver disease, cancer, and gout were independent mortality predictors. There was no significant difference in the mortality for SA between upper limb affected and lower limb affected. Conclusions: This study delineated that SA significantly increased the long-term mortality in geriatric participants. For the increasing aging population worldwide, strategies for the prevention and treatment of SA and concomitant control of comorbidities are very important.",
author = "Wu, {Chia Jung} and Huang, {Chien Cheng} and Weng, {Shih Feng} and Chen, {Ping Jen} and Hsu, {Chien Chin} and Wang, {Jhi Joung} and How-Ran Guo and Lin, {Hung Jung}",
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Septic arthritis significantly increased the long-term mortality in geriatric patients. / Wu, Chia Jung; Huang, Chien Cheng; Weng, Shih Feng; Chen, Ping Jen; Hsu, Chien Chin; Wang, Jhi Joung; Guo, How-Ran; Lin, Hung Jung.

In: BMC geriatrics, Vol. 17, No. 1, 178, 09.08.2017.

Research output: Contribution to journalArticle

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T1 - Septic arthritis significantly increased the long-term mortality in geriatric patients

AU - Wu, Chia Jung

AU - Huang, Chien Cheng

AU - Weng, Shih Feng

AU - Chen, Ping Jen

AU - Hsu, Chien Chin

AU - Wang, Jhi Joung

AU - Guo, How-Ran

AU - Lin, Hung Jung

PY - 2017/8/9

Y1 - 2017/8/9

N2 - Background: The elderly are predisposed to septic arthritis (SA) because of the aging nature and increasing comorbidities. SA may in turn increase the long-term mortality in the geriatric patients; however, it remains unclear. We conducted this prospective nationwide population-based cohort study to clarify this issue. Methods: Using Taiwan National Health Insurance Research Database (NHIRD), we identified 1667 geriatric participants (≥ 65 years) with SA and 16,670 geriatric participants without SA matched at a ratio of 1:10 by age, sex, and index date between 1999 and 2010. A comparison of the long-term mortality between the two cohorts through follow-up until 2011 was performed. Results: Geriatric participants with SA had a significantly increased mortality than those without SA [Adjusted hazard ratio (AHR): 1.49, 95% confidence interval (CI): 1.34-1.66], particularly the old elderly (≥ 85 years, AHR: 2.12, 95% CI: 1.58-2.84) and males (AHR: 1.54, 95% CI: 1.33-1.79). These results were stated after adjustment for osteoarthritis, diabetes, gout, renal disease, liver disease, cancer, rheumatoid arthritis, systemic lupus erythematosus, alcoholism, and human immunodeficiency virus infection. The increased mortality risk was highest in the first month (AHR: 3.93, 95% CI: 2.94-5.25) and remained increased even after following up for 2-4 years (AHR: 1.30, 95% CI: 1.03-1.65). After Cox proportional hazard regression analysis, SA (AHR: 1.37, 95% CI: 1.20-1.56), older age (≥ 85 years, AHR: 1.79, 95% CI: 1.59-2.02, 75-84 years, AHR: 1.65, 95% CI: 1.53-1.78), male sex, diabetes, renal disease, liver disease, cancer, and gout were independent mortality predictors. There was no significant difference in the mortality for SA between upper limb affected and lower limb affected. Conclusions: This study delineated that SA significantly increased the long-term mortality in geriatric participants. For the increasing aging population worldwide, strategies for the prevention and treatment of SA and concomitant control of comorbidities are very important.

AB - Background: The elderly are predisposed to septic arthritis (SA) because of the aging nature and increasing comorbidities. SA may in turn increase the long-term mortality in the geriatric patients; however, it remains unclear. We conducted this prospective nationwide population-based cohort study to clarify this issue. Methods: Using Taiwan National Health Insurance Research Database (NHIRD), we identified 1667 geriatric participants (≥ 65 years) with SA and 16,670 geriatric participants without SA matched at a ratio of 1:10 by age, sex, and index date between 1999 and 2010. A comparison of the long-term mortality between the two cohorts through follow-up until 2011 was performed. Results: Geriatric participants with SA had a significantly increased mortality than those without SA [Adjusted hazard ratio (AHR): 1.49, 95% confidence interval (CI): 1.34-1.66], particularly the old elderly (≥ 85 years, AHR: 2.12, 95% CI: 1.58-2.84) and males (AHR: 1.54, 95% CI: 1.33-1.79). These results were stated after adjustment for osteoarthritis, diabetes, gout, renal disease, liver disease, cancer, rheumatoid arthritis, systemic lupus erythematosus, alcoholism, and human immunodeficiency virus infection. The increased mortality risk was highest in the first month (AHR: 3.93, 95% CI: 2.94-5.25) and remained increased even after following up for 2-4 years (AHR: 1.30, 95% CI: 1.03-1.65). After Cox proportional hazard regression analysis, SA (AHR: 1.37, 95% CI: 1.20-1.56), older age (≥ 85 years, AHR: 1.79, 95% CI: 1.59-2.02, 75-84 years, AHR: 1.65, 95% CI: 1.53-1.78), male sex, diabetes, renal disease, liver disease, cancer, and gout were independent mortality predictors. There was no significant difference in the mortality for SA between upper limb affected and lower limb affected. Conclusions: This study delineated that SA significantly increased the long-term mortality in geriatric participants. For the increasing aging population worldwide, strategies for the prevention and treatment of SA and concomitant control of comorbidities are very important.

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