Population-based study of outcomes of patients with juvenile idiopathic arthritis (JIA) compared to non-JIA subjects

• Published in: Seminars in arthritis and rheumatism Vol. 46; no. 4; pp. 439 - 443
• Main Authors: Krause, Megan L., MD, Zamora-Legoff, Jorge A., MD, Crowson, Cynthia S., MS, Muskardin, Theresa Wampler, MD, Mason, Thomas, MD, Matteson, Eric L., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2017
• Subjects: Adolescent; Adult; Arthritis, Juvenile - epidemiology; Case-Control Studies; Child; Child, Preschool; Comorbidity; Depression; Depression - epidemiology; Female; Follow-Up Studies; Health Services - utilization; Healthcare utilization; Hospitalization - statistics & numerical data; Humans; Juvenile idiopathic arthritis; Male; Minnesota - epidemiology; Orthopedic Procedures - statistics & numerical data; Pregnancy; Pregnancy Outcome - epidemiology; Pregnancy Rate; Rheumatology; Surgical Procedures, Operative - statistics & numerical data; Young Adult; Healthcare utilization; Depression; Juvenile idiopathic arthritis
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2016.07.003

Abstract 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.