| アブストラクト | OBJECTIVES: To investigate the associations between smoking status, smoking cessation and hospitalisations for cardiovascular events (CVE) and respiratory tract infections (RTI) in an inception cohort of patients with rheumatoid arthritis (RA). METHODS: The study was set within UK primary care electronic health records (the Clinical Practice Research Datalink) linked to hospital inpatient data (Hospital Episode Statistics). Patients with RA were followed from diagnosis to hospitalisation with a record of CVE or RTI, leaving their general practice, death, or 10 January 2012, whichever was earliest. Smoking status (never, current, former) was defined using primary care data and could vary over time. Survival analysis was performed using Cox regression (first event) and conditional risk set models (multiple RTIs). RESULTS: 5677 patients were included in the cohort: 68% female, median age 61 years. The age-adjusted and sex-adjusted risks of hospitalisation for CVE or RTI were more than twice as high in current vs never smokers (CVE HR (95% CI) 2.19 (1.44 to 3.31); RTI 2.18 (1.71 to 2.78)). The risks for both outcomes were significantly higher in current compared with former smokers (CVE 1.51 (1.04 to 2.19), RTI 1.29 (1.04 to 1.61)). For each additional year of smoking cessation, the risk of first CVE and RTI hospitalisation fell significantly, approximately 25% and 15% respectively in the adjusted models. CONCLUSIONS: Patients with RA who smoke have an increased risk of hospitalisation with CVE or RTI compared with never and former smokers. The risk decreases for each additional year of smoking cessation. Patients with RA who smoke should be advised to stop smoking. |
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| 組織名 | NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester;University Hospitals NHS Foundation Trust, Manchester Academic Health Science;Centre, Manchester, UK.;Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal;Research, Division of Musculoskeletal and Dermatological Sciences, School of;Biological Sciences, Faculty of Biology, Medicine and Health, University of;Manchester, Manchester Academic Health Science Centre, Manchester, UK.;Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.;NIHR Manchester Biomedical Research Centre, Central Manchester University;Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre,;Manchester, UK. |
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