Meng-Chang Ding1, Ming-Shao Tsai1,2,3,4, Yao-Hsu Yang2,5,6, Chia-Yen Liu2, Yao-Te Tsai1,2,4, Cheng-Ming Hsu1,3,4, Ching-Yuan Wu1,3,5,6, Pey-Jium Chang3, Ko-Ming Lin3,4,7, Geng-He Chang8,9,10,11. 1. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, 6, W. Sec., Jiapu Rd., Puzih, Chiayi County, 613, Taiwan. 2. Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chang Gung Memorial Hospital, Chiayi, Taiwan. 3. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University At Taoyuan, Taoyuan, Taiwan. 4. Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 5. Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. 6. School of Traditional Chinese Medicine, College of Medicine, Chang Gung University At Taoyuan, Taoyuan, Taiwan. 7. Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Chiayi, Taiwan. 8. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, 6, W. Sec., Jiapu Rd., Puzih, Chiayi County, 613, Taiwan. genghechang@gmail.com. 9. Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chang Gung Memorial Hospital, Chiayi, Taiwan. genghechang@gmail.com. 10. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University At Taoyuan, Taoyuan, Taiwan. genghechang@gmail.com. 11. Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. genghechang@gmail.com.
Abstract
PURPOSE: The peritonsillar abscess (PTA)-rheumatoid arthritis (RA) association remains unclear. Here, the effects of RA on PTA incidence and prognosis are elucidated. METHODS: We compared PTA incidence and prognosis of 30,706 RFCIP-registered patients with RA (RA cohort) with matched individuals without RA from another database of 1 million randomly selected people representing Taiwan's population (non-RA cohort). RESULTS: The RA cohort had significantly higher PTA incidence [incidence rate ratio (IRR) (95% CI) 1.73 (1.10-2.71), P = 0.017) and cumulative incidence (P = 0.016, Kaplan-Meier curves). Cox regression analyses demonstrated RA cohort to have an estimated 1.72-fold increased PTA risk (95% CI 1.09-2.69, P = 0.019). PTA was more likely within the first 5 years of RA diagnosis (for < 1, 1-5, and ≥ 5 postdiagnosis years, IRRs: 2.67, 2.31, and 1.10, respectively, and P = 0.063, 0.021, and 0.794, respectively; average onset duration: 4.3 ± 3.3 years after RA diagnosis). PTA increased length of hospital stay significantly and risk of complication with deep neck infection nonsignificantly [6.5 ± 4.5 vs 4.6 ± 2.8 days (P = 0.045) and 18.52% vs 7.81% (P = 0.155), respectively]. Moreover, RA-cohort patients not receiving RA therapy exhibited 5.06-fold higher PTA risk than those receiving RA-related therapy (95% CI 1.75-14.62, P = 0.003). CONCLUSIONS: In patients with RA, PTA incidence is the highest within 5 years of RA diagnosis, and RA therapy is essential for reducing PTA risk. LEVEL OF EVIDENCE: 4.
PURPOSE: The peritonsillar abscess (PTA)-rheumatoid arthritis (RA) association remains unclear. Here, the effects of RA on PTA incidence and prognosis are elucidated. METHODS: We compared PTA incidence and prognosis of 30,706 RFCIP-registered patients with RA (RA cohort) with matched individuals without RA from another database of 1 million randomly selected people representing Taiwan's population (non-RA cohort). RESULTS: The RA cohort had significantly higher PTA incidence [incidence rate ratio (IRR) (95% CI) 1.73 (1.10-2.71), P = 0.017) and cumulative incidence (P = 0.016, Kaplan-Meier curves). Cox regression analyses demonstrated RA cohort to have an estimated 1.72-fold increased PTA risk (95% CI 1.09-2.69, P = 0.019). PTA was more likely within the first 5 years of RA diagnosis (for < 1, 1-5, and ≥ 5 postdiagnosis years, IRRs: 2.67, 2.31, and 1.10, respectively, and P = 0.063, 0.021, and 0.794, respectively; average onset duration: 4.3 ± 3.3 years after RA diagnosis). PTA increased length of hospital stay significantly and risk of complication with deep neck infection nonsignificantly [6.5 ± 4.5 vs 4.6 ± 2.8 days (P = 0.045) and 18.52% vs 7.81% (P = 0.155), respectively]. Moreover, RA-cohort patients not receiving RA therapy exhibited 5.06-fold higher PTA risk than those receiving RA-related therapy (95% CI 1.75-14.62, P = 0.003). CONCLUSIONS: In patients with RA, PTA incidence is the highest within 5 years of RA diagnosis, and RA therapy is essential for reducing PTA risk. LEVEL OF EVIDENCE: 4.
Entities:
Keywords:
Autoimmune; Cervical abscess; Cervical cellulitis; National health insurance research database; Nationwide database; Risk factor
Authors: Jason K M Chau; Hadi R Seikaly; Jeffery R Harris; Cristina Villa-Roel; Craig Brick; Brian H Rowe Journal: Laryngoscope Date: 2013-07-09 Impact factor: 3.325
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