The impact of rehabilitation frequency on the risk of stroke in patients with rheumatoid arthritis

• Published in: PloS one Vol. 15; no. 1; p. e0227514
• Main Authors: Cheng, Yuan-Yang, Chang, Shin-Tsu, Kao, Chung-Lan, Chen, Yi-Huei, Lin, Ching-Heng
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.01.2020; Public Library of Science (PLoS)
• Subjects: Age; Aged; Arthritis; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - pathology; Arthritis, Rheumatoid - rehabilitation; Autoimmune diseases; Biological weapons; Biology and Life Sciences; Case-Control Studies; Chi-square test; Comorbidity; Databases, Factual; Diabetes Complications; Diabetes mellitus; Diabetes Mellitus - pathology; Drug dosages; Exercise; Female; Health risks; Heart rate; Hospitals; Humans; Hyperlipidemia; Hypertension; Hypertension - complications; Inflammation; Logistic Models; Male; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Odds Ratio; Patients; Quality of life; Regression analysis; Rehabilitation; Rheumatoid arthritis; Risk; Risk Factors; Severity of Illness Index; Statistical tests; Stroke; Stroke - complications; Stroke - diagnosis; Studies; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0227514

Patients with rheumatoid arthritis are at higher risk of developing stroke due to augmented systemic inflammation. While regular exercise has been shown to reduce inflammation in human subjects, the purpose of our study is to determine whether increased frequency of rehabilitation is protective against stroke or not. A total of 16,224 rheumatoid arthritis patients with a catastrophic illness certificate were identified in our database from 2000 to 2006, and 663 of them developed stroke before the end of 2013. After statistically matching for age, sex, and the time interval between the diagnosis of rheumatoid arthritis and stroke, 642 patients without stroke were identified as the control group. Analyses with Student's t test and Chi-square test were done to compare the clinical characteristics of patients with and without stroke, and logistic regression analysis was then performed to evaluate the odds ratio of stroke. Higher odds ratio of stroke was revealed in patients with hypertension, diabetes mellitus, and moderate degree of rheumatoid arthritis disease severity. Furthermore, more than 40 rehabilitation sessions per year reduced the risk of developing stroke in patients with moderate disease severity. Physical activities brought by more rehabilitation sessions are beneficial and should be encouraged in patients with rheumatoid arthritis, particularly for those with higher disease activity but not taking biologic agents.