Background: Patients diagnosed with rheumatic and musculoskeletal diseases (RMD) often necessitate in-patient care for a variety of reasons, including treatment for symptom exacerbation, disease flare-ups, disease or treatment complications. In contrast to those requiring outpatient care, these patients typically present with more severe and complex diseases, often associated with higher mortality rates.

Objectives: Our hospital serves as the tertiary referral center for rheumatology services in the northern states of Malaysia. These regions exhibit lower household incomes, limited resources, and are predominantly rural compared to urban areas. Our objective is to analyze our in-patient rheumatology service, delving into patient demographics, diagnosis, and in-patient mortality.

Methods: We retrospectively analyze our in-patient registries and referrals from April 2017 to December 2023, focusing on patient demographics, rheumatology diagnosis, and discharge status. In-patient mortality, referring to death occurring during a patient’s hospital stay, was specifically examined. It involved detailed reviews of clinical notes, blood investigations, medications, and the cause of death. The dataset was then analyzed using statistical software.

Results: A total of 2276 patients received treatment during these periods. Commonly encountered diagnosis included systemic lupus erythematosus (SLE) n= 926 (40.7%), gouty arthritis n= 408 (17.9%), inflammatory arthritis n= 273 (12%) (including rheumatoid arthritis n= 156), vasculitis n= 110 (4.8%), systemic sclerosis n= 83 (3.6%), and idiopathic inflammatory myositis n= 46 (2%). There were more female patients n= 1556 (68.3%) compared to male patients n= 722 (31.7%).

79 patients required intensive care unit or cardiac care unit admission during this period for ventilatory support, or renal replacement therapy. Common referrals were from the medical department (74%), surgical department (7%), obstetrics & gynecology department (6%), cardiology department (5%), orthopedics department (4%), and respiratory department (4%).

There were 95 (4.2%) in-patient mortality; with a median age of 51 years. The primary causes of death were infections n= 60 (63.2%), followed by active disease n= 18 (18.9%), cardiovascular events n= 12 (12.6%), malignancy n= 3 (3.2%), and upper gastrointestinal bleeding n= 2 (2.1%).

Conclusion: In our cohort of patients, infections emerged as the most prevalent cause of death, followed by active disease and cardiovascular complication. Our finding is consistent with previously published studies. This valuable insight emphasizes the need for increased vigilance in improving strategies for the management and prevention of infections among individuals with RMD.

REFERENCES: NIL.

Acknowledgements: Dr Tan Chou Luan.

Disclosure of Interests: None declared.