Decrease of RA-related orthopaedic surgery of the upper limbs between 1998 and 2004: data from 54 579 Swedish RA inpatients

• Published in: Rheumatology (Oxford, England) Vol. 47; no. 4; pp. 491 - 494
• Main Authors: Weiss, R. J., Ehlin, A., Montgomery, S. M., Wick, M. C., Stark, A., Wretenberg, P.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2008; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Arthritis, Rheumatoid - epidemiology; Arthritis, Rheumatoid - surgery; Arthroplasty, Replacement - utilization; Biological and medical sciences; Diseases of the osteoarticular system; Elbow Joint - surgery; Epidemiology; Female; Hand Joints - surgery; Hospitalization - statistics & numerical data; Humans; Inflammatory joint diseases; Kirurgi; Kirurgisk forskning; Length of Stay - statistics & numerical data; Length of Stay - trends; Length of Stay/statistics & numerical data/trends; Male; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Orthopaedic surgery; Orthopaedics; Orthopedic Procedures - trends; Orthopedic Procedures - utilization; Orthopedic Procedures/trends/utilization; Orthopedic surgery; Ortopedi; Rheumatoid arthritis; Shoulder Joint - surgery; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical research; Sweden - epidemiology; Upper Extremity - surgery; Upper limbs; Sweden; Immunopathology; Diseases of the osteoarticular system; Rheumatology; Autoimmune disease; Inflammatory joint disease; Epidemiology; Chronic; Orthopedic surgery; Treatment; Rheumatoid arthritis; Upper limb; Orthopaedic surgery; Upper limbs; Arthritis; Arthroplasty; Replacement/utilization; Rheumatoid/epidemiology/surgery
• ISSN: 1462-0324; 1462-0332; 1462-0332
• DOI: 10.1093/rheumatology/ken009

Objectives. To describe the overall use and temporal trends in orthopaedic upper limb surgery associated with RA on a nation wide basis in Sweden between 1998 and 2004. Methods. Data for all inpatient visits during 1998–2004 for patients older than 18 yrs with RA-related diagnoses were extracted from the Swedish National Hospital Discharge Registry (SNHDR). The SNHDR prospectively collects data on all hospital admissions in Sweden according to the International Classification of Diseases (ICD). Data were analysed with respect to orthopaedic surgery of the hand, elbow and shoulder. Results. During the study period, 54 579 individual RA patients were admitted to a Swedish hospital and 9% of these underwent RA-related surgery of the upper limbs. The RA patient cohort underwent a total of 8251 RA-related upper limb surgical procedures. The hand (77%) was most frequently operated on, followed by the shoulder (13%) and the elbow (10%). There was a statistically significant decrease of 31% for all admissions associated with RA-related upper limb surgery during 1998–2004 (P = 0.001). Some 10% of all RA-related upper limb surgery was due to total joint arthroplasties (TJAs), mostly for the elbow (59%). During 1998–2004, all TJAs, elbow-TJAs and shoulder-TJAs had a stable occurrence. In contrast, the overall numbers of hand-TJAs significantly increased (P = 0.009). Conclusions. Rates of RA-related upper limb surgery decreased and TJAs had a stable occurrence in Sweden during 1998–2004. The findings of this study may reflect trends in disease management and health outcomes of RA patients in Sweden.