Evaluation of Patients with Rheumatic Diseases Admitted at Emergency Department: Five-Year Analysis in a Single Center

BACKGROUND Chronic inflammatory diseases can lead to emergency admissions with various acute complications.Unfortunately,there is limited data on emergency admissions due to rheumatologic diseases.
OBJECTIVES To evaluate the patients with rheumatic diseases presenting to the ED.
METHODS 1788 patients with a diagnosis of inflammatory rheumatic disease admitted to the emergency department (ED) of a tertiary university hospital between March 2016 and March 2021 were included.The patients' sociodemographic and clinical characteristics, diagnosis, and treatments in the ED were recorded. Patients' complaints were classified as rheumatologic or non-rheumatologic.
RESULTS Over five years, 1788 patients with an inflammatory rheumatic disease presented to the ED.The mean duration of rheumatologic disease was 7±3.4 years, and the mean number of emergency admissions was 4.4±5.The four most common groups attending the ED were patients with rheumatoid arthritis, ankylosing spondylitis, familial Mediterranean fever, and vasculitis.Of the complaints of the 1788 ED visitors, 1106 (61.9%) were rheumatologic, 681 (38.1%) were non-rheumatologic and other acute or chronic conditions.Twenty-three patients (1.3%) had rheumatic disease and died after admission to the ED.When the univariable model results are examined, the risk of hospitalization increases 1.024 times with increasing age.The risk of hospitalization is 2.318 times higher in those with ankylosing spondylitis and 2.722 times in those with rheumatoid arthritis compared to those with a diagnosis of vasculitis.The risk of hospitalization in patients with comorbid diseases is 1.807 times higher than those without.When the results of the multivariable model are examined, the risk of hospitalization is 2.227 times higher in those with ankylosing spondylitis and 2.615 times in those with rheumatoid arthritis compared to those with vasculitis. Other risk factors were not statistically significant (p>0.050).
CONCLUSION Patients with rheumatic disease most frequently presented to the ED with musculoskeletal complaints and were discharged from the ED.True rheumatologic emergencies are rare, but ED physicians should be aware of serious and life-threatening conditions.

as reported in: Int J Clin Pract. 2021 Sep 13 e14837 [Epub ahead of print]