Background: Ophthalmic conditions are a serious extraarticular complication of systemic rheumatic disease. Despite the clinical significance of these conditions in patients, their impact on hospital outcomes remains underexplored.

Objectives: This study investigates how ophthalmic conditions affect hospitalization outcomes, including length of stay, discharge status, and healthcare costs, while considering demographic and hospital factors, and assessing disparities related to race/ethnicity, income, and insurance status.

Methods: This retrospective cross-sectional study analyzed data from the National Inpatient Sample (NIS) database (2018-2021) to assess hospital outcomes in patients with systemic rheumatic diseases and ophthalmic conditions. Inclusion criteria were adult hospitalizations with a principal or secondary diagnosis of SRDs (Sjögren’s syndrome, systemic lupus erythematosus, rheumatoid arthritis, spondyloarthritis, axial spondyloarthritis) and one or more ophthalmic conditions. Ophthalmic conditions were categorized into groups based on ICD-10 codes (Optic neuritis/neuropathy, scleritis/episcleritis, uveitis, retinal vasculitis, vascular diseases, and corneal/ocular surface conditions). Primary outcomes included in-hospital mortality, while secondary outcomes included non-home discharge, length of stay, and inpatient charges. Predictors included ophthalmic condition, race, ethnicity, insurance status, and income quartile, adjusted for potential confounders such as age, hospital characteristics, and comorbidities. Logistic regression and propensity score matching were used to assess associations.

Results: Of the total 4,328,218 individual hospitalizations of patients with rheumatic condition, 19,164 (0.5%) had one or more ophthalmic conditions. The distribution of conditions included corneal conditions (47%), neuropathy (17%), vascular conditions (16%), scleritis (10%), uveitis (5.6%), and vasculitis (4.4%). Patients with ophthalmic conditions were more likely to be Black or Asian, have private insurance, and be treated at larger, urban, teaching hospitals. Those with ophthalmic conditions were associated with significantly higher hospital charges ($43,965 vs. $39,869, p= 0.005) and longer length of stay (4.0 vs. 3.0 days, p<0.001), but there were no significant differences in mortality (2.1% vs. 2.5%, p=0.08). Adjusted analysis revealed that smaller hospitals and those with private or Medicaid insurance were associated with lower mortality.

Conclusion: Patients with ophthalmic conditions faced significantly higher hospital charges and longer stays, yet their mortality was no higher than those without eye conditions. They were more likely to be Black or Asian, have higher incomes, and have private or Medicaid insurance. These findings emphasize the need for early management of eye conditions. Addressing ophthalmic issues during hospitalization or arranging proper follow-up care could reduce costs, shorten stays, and improve patient outcomes, highlighting the value of multidisciplinary care and enhanced healthcare access.

REFERENCES: NIL.

Acknowledgements: Rheumatology Research Foundation Medical Student Preceptorship Grant; NIH K23 Research Career Development Award.

Disclosure of Interests: Insa Mannstadt: None declared, Yiyuan Wu: None declared, Ravi Parikh: None declared, Bella Mehta Horizon: Advisory board Novartis: Paid consultant.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.