Background: Rheumatoid arthritis is a chronic systemic inflammatory joint disease, mainly affecting women and characterized by destructive symmetric polyarthritis and extra-articular organ involvement.

Objectives: We aim to evaluate sex differences in hospitalized rheumatoid arthritis patients and how the difference may impact outcomes and current management guidelines.

Methods: We analyzed the 2017 to 2021 United States National Inpatient Sample (NIS) data of all patients aged 18 years and above with a discharge diagnosis of rheumatoid arthritis. The NIS database is the largest publicly available database of patients hospitalized in the United States and contains approximately 20% stratified samples of all hospital discharges in the United States.

Results: There were 544100 patient admissions with a discharge diagnosis of rheumatoid arthritis, of which 142496 (26.2%) were males and 401539 (73.8%) were females. The mean age of patients with rheumatoid arthritis was 67.8 years, and the mean length of hospital stay was 5.2 days. In the multivariate analysis, males were associated with an increased risk of pulmonary complications, including interstitial lung disease (OR 1.27), pleural effusion (OR 1.15), and pneumothorax (OR 1.51), all with p<0.001. In addition, males had an increased risk of cardiovascular complications, including congestive heart failure (OR 1.1), atrial fibrillation (OR 1.49), heart block (OR 1.32), and acute myocardial infarction (OR 1.35), all with p<0.001. There was also an increased risk of all-cause mortality in males than females (OR 1.07, p<0.001).

Conclusion: Our analysis suggests that although males are far less likely than females to have rheumatoid arthritis, they are more likely to have cardiovascular and pulmonary complications of rheumatoid arthritis and worse in-patient all-cause mortality. A slightly more aggressive management approach, including early initiation of disease-modifying antirheumatic drugs, may be warranted in males with rheumatoid arthritis.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© 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.