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 RTI s).
Results:
5677 patients were included in the cohort: 68% female, median age 61 years. The age-adjusted and sexadjusted 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.
Rebecca M Joseph, Mohammad Movahedi, William G Dixon, Deborah PM Symmons, Risks of smoking and benefits of smoking cessation on hospitalisations for cardiovascular events and respiratory infection in patients with rheumatoid arthritis a retrospective cohort study using the Clinical Practice Research Datalink. RMD Open, 3(2), e000506, 2017.
Code | Description | Category | Coding System (ICD-10) | Entity type |
---|---|---|---|---|
A15 | Respiratory tuberculosis, bacteriologically and histologically confirmed | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.0 | Tuberculosis of lung, confirmed by sputum microscopy with or without culture | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.1 | Tuberculosis of lung, confirmed by culture only | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.2 | Tuberculosis of lung, confirmed histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.3 | Tuberculosis of lung, confirmed by unspecified means | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.4 | Tuberculosis of intrathoracic lymph nodes, confirmed bacteriologically and histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.5 | Tuberculosis of larynx, trachea and bronchus, confirmed bacteriologically and histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.6 | Tuberculous pleurisy, confirmed bacteriologically and histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.7 | Primary respiratory tuberculosis, confirmed bacteriologically and histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.8 | Other respiratory tuberculosis, confirmed bacteriologically and histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A15.9 | Respiratory tuberculosis unspecified, confirmed bacteriologically and histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16 | Respiratory tuberculosis, not confirmed bacteriologically or histologically | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.0 | Tuberculosis of lung, bacteriologically and histologically negative | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.1 | Tuberculosis of lung, bacteriological and histological examination not done | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.2 | Tuberculosis of lung, without mention of bacteriological or histological confirmation | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.3 | Tuberculosis of intrathoracic lymph nodes, without mention of bacteriological or histological confir | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.4 | Tuberculosis of larynx, trachea and bronchus, without mention of bacteriological or histological con | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.5 | Tuberculous pleurisy, without mention of bacteriological or histological confirmation | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.7 | Primary respiratory tuberculosis without mention of bacteriological or histological confirmation | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.8 | Other respiratory tuberculosis, without mention of bacteriological or histological confirmation | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A16.9 | Respiratory tuberculosis unspecified, without mention of bacteriological or histological confirmatio | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
A48.1 | Legionnaires disease | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J12 | Viral pneumonia, not elsewhere classified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J12.0 | Adenoviral pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J12.1 | Respiratory syncytial virus pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J12.2 | Parainfluenza virus pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J12.3 | Human metapneumovirus pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J12.8 | Other viral pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J12.9 | Viral pneumonia, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J13 | Pneumonia due to Streptococcus pneumoniae | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J14 | Pneumonia due to Haemophilus influenzae | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15 | Bacterial pneumonia, not elsewhere classified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.0 | Pneumonia due to Klebsiella pneumoniae | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.1 | Pneumonia due to Pseudomonas | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.2 | Pneumonia due to staphylococcus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.3 | Pneumonia due to streptococcus, group B | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.4 | Pneumonia due to other streptococci | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.5 | Pneumonia due to Escherichia coli | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.6 | Pneumonia due to other aerobic Gram-negative bacteria | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.7 | Pneumonia due to Mycoplasma pneumoniae | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.8 | Other bacterial pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J15.9 | Bacterial pneumonia, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J16 | Pneumonia due to other infectious organisms, not elsewhere classified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J16.0 | Chlamydial pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J16.8 | Pneumonia due to other specified infectious organisms | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J17 | Pneumonia in diseases classified elsewhere | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J17.0 | Pneumonia in bacterial diseases classified elsewhere | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J17.1 | Pneumonia in viral diseases classified elsewhere | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J17.2 | Pneumonia in mycoses | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J17.3 | Pneumonia in parasitic diseases | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J17.8 | Pneumonia in other diseases classified elsewhere | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J18 | Pneumonia, organism unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J18.0 | Bronchopneumonia, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J18.1 | Lobar pneumonia, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J18.2 | Hypostatic pneumonia, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J18.8 | Other pneumonia, organism unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J18.9 | Pneumonia, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20 | Acute bronchitis | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.0 | Acute bronchitis due to Mycoplasma pneumoniae | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.1 | Acute bronchitis due to Haemophilus influenzae | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.2 | Acute bronchitis due to streptococcus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.3 | Acute bronchitis due to coxsackievirus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.4 | Acute bronchitis due to parainfluenza virus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.5 | Acute bronchitis due to respiratory syncytial virus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.6 | Acute bronchitis due to rhinovirus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.7 | Acute bronchitis due to echovirus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.8 | Acute bronchitis due to other specified organisms | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J20.9 | Acute bronchitis, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J21 | Acute bronchiolitis | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J21.0 | Acute bronchiolitis due to respiratory syncytial virus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J21.1 | Acute bronchiolitis due to human metapneumovirus | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J21.8 | Acute bronchiolitis due to other specified organisms | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J21.9 | Acute bronchiolitis, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J22 | Unspecified acute lower respiratory infection | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J40 | Bronchitis, not specified as acute or chronic | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J44.0 | Chronic obstructive pulmonary disease with acute lower respiratory infection | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J44.1 | Chronic obstructive pulmonary disease with acute exacerbation, unspecified | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J85 | Abscess of lung and mediastinum | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J85.0 | Gangrene and necrosis of lung | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J85.1 | Abscess of lung with pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J85.2 | Abscess of lung without pneumonia | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J85.3 | Abscess of mediastinum | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J86 | Pyothorax | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J86.0 | Pyothorax with fistula | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
J86.9 | Pyothorax without fistula | diagnostic | ICD-10 | res52: respiratory tract infection ICD-10 |
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Format | API |
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R Package |
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To Export Phenotype Code List:
Format | API |
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CSV | site_root/phenotypes/PH488/version/1521/export/codes/ |
R Package |
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Version ID |
Name | Owner | Publish date | |
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1521 | Respiratory Tract Infection | ieuan.scanlon | 2021-10-26 | currently shown |
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