TY - JOUR
T1 - Risk factors for infection in patients with remitted rheumatic diseases treated with glucocorticoids
AU - Matsumoto, Yoshinori
AU - Sada, Kenei
AU - Narazaki, Mariko
AU - Toyota, Noriko
AU - Yamanaka, Ryutaro
AU - Sugiyama, Koichi
AU - Wakabayashi, Hiroshi
AU - Kawabata, Tomoko
AU - Otsuka, Fumio
AU - Makino, Hirofumi
PY - 2011
Y1 - 2011
N2 - It is well known that infection is one of the major causes of morbidity and mortality in rheumatic disease patients treated with high-dose glucocorticoids, especially in the early phase after achievement of disease remission. The aim of this study was to identify the risk factors for infection, with a focus on the dose of glucocorticoids administered, following the achievement of disease remission in rheumatic diseases patients. We retrospectively analyzed the medical records of rheumatic disease patients who had been treated with glucocorticoids. The primary endpoint was the incidence rate of infection during a period from 1 to 2 months after the commencement of treatment. From April 2006 to March 2010, 19 of 92 patients suffered from infection during the observation period. Age ≥ 65 yrs, presence of interstitial pneumonia, diagnosis of systemic vasculitis and serum creatinine levels ≥ 2.0mg/dl were found to be univariate predictors for infection. However, only the presence of interstitial pneumonia was an independent risk factor for infection (HR = 4.50, 95%CI = 1.65 to 14.44) by the Cox proportional hazard model. Even after achievement of clinical remission, careful observation is needed for patients with interstitial pneumonia, more so than for those receiving high-dose glucocorticoids.
AB - It is well known that infection is one of the major causes of morbidity and mortality in rheumatic disease patients treated with high-dose glucocorticoids, especially in the early phase after achievement of disease remission. The aim of this study was to identify the risk factors for infection, with a focus on the dose of glucocorticoids administered, following the achievement of disease remission in rheumatic diseases patients. We retrospectively analyzed the medical records of rheumatic disease patients who had been treated with glucocorticoids. The primary endpoint was the incidence rate of infection during a period from 1 to 2 months after the commencement of treatment. From April 2006 to March 2010, 19 of 92 patients suffered from infection during the observation period. Age ≥ 65 yrs, presence of interstitial pneumonia, diagnosis of systemic vasculitis and serum creatinine levels ≥ 2.0mg/dl were found to be univariate predictors for infection. However, only the presence of interstitial pneumonia was an independent risk factor for infection (HR = 4.50, 95%CI = 1.65 to 14.44) by the Cox proportional hazard model. Even after achievement of clinical remission, careful observation is needed for patients with interstitial pneumonia, more so than for those receiving high-dose glucocorticoids.
KW - Glucocorticoids
KW - Infection
KW - Interstitial pneumonia
KW - Rheumatic disease
KW - Risk factors
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M3 - Article
C2 - 22037270
AN - SCOPUS:83455255278
VL - 65
SP - 329
EP - 334
JO - Acta Medica Okayama
JF - Acta Medica Okayama
SN - 0386-300X
IS - 5
ER -