title: Population-based study of outcomes of patients with juvenile idiopathic arthritis (JIA) compared to non-JIA subjects.
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.
authors: Division of Rheumatology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905. Electronic address: krause.megan@mayo.edu.
authors: Megan L
authors: ML
authors: Krause
authors: Division of Rheumatology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905.
authors: Jorge A
authors: JA
authors: Zamora-Legoff
authors: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN.
authors: Cynthia S
authors: CS
authors: Crowson
authors: Division of Rheumatology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905.
authors: Theresa Wampler
authors: TW
authors: Muskardin
authors: Division of Rheumatology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905.
authors: Thomas
authors: T
authors: Mason
authors: Division of Rheumatology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN.
authors: Eric L
authors: EL
authors: Matteson
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018873:Pregnancy Rate; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Depression; Healthcare utilization; Juvenile idiopathic arthritis