AB0829 WHAT ARE THE DIFFERENCES BETWEEN YOUNG AND ELDERLY SUBJECTS IN URGENT RHEUMATOLOGY CONSULTATIONS?
Authors: R. Assadi, Z. El Ouali, S. Lahrichi, K. Nassar, S. Janani
Journal: Annals of the Rheumatic Diseases (2021)

Background: The pattern of rheumatological diseases shows significant differences depending on age. It is commonly admitted that inflammatory rheumatic diseases is the prerogative of young people (1), while degenerative pathology is more important in older ages (2). In the context of the emergency, little epidemiological data exist about the differences between young and old populations. Objectives: To study the influence of age on emergency rheumatology consultations received in the Department of Rheumatology of the University Hospital of Ibn Rochd. Methods: We conducted a retrospective study on the 2019 emergency consultations register of the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. Patients were divided in 2 groups: young subjects included patients aged less than 65 years, and the elderly subjects included people aged 65 and above. The studied parameters were gender, medical coverage, socio-professional category, reasons for consultation, joint involvement, duration of symptoms, diagnoses, and treatments. Results: 407 emergency consultations were carried out, including 81 in the elderly (19.9%) and 326 in young subjects (80.1%). The characteristics are summed up in Table 1. Although we noted a female predominance in both groups, men were more represented in the elderly group. Radiculalgia was a more frequent reason for consultation in the elderly population, while arthralgia was more frequent in the young population. Young subjects more frequently had peripheral joints complaints. Degenerative and tumor pathologies were more common in the elderly population, while inflammatory, septic, and tendon pathologies were more prominent in the young population. Regarding treatments, non-steroidal anti-inflammatory drugs were more prescribed in young subjects, while the other treatments had a homogeneous distribution in the two groups. Conclusion: In our emergency unit, the epidemiological distribution of our patients according to age matches the general epidemiological characteristics of rheumatological pathologies: inflammatory causes are more frequent in young ages, while degenerative pathologies are found at a later age. References: [1]Kobak S, Bes C. An autumn tale: geriatric rheumatoid arthritis. Therapeutic Advances in Musculoskeletal. 2018 Jan;10(1):3–11. [2]Loeser RF. The Role of Aging in the Development of Osteoarthritis. Trans Am Clin Climatol Assoc. 2017;128:44–54. Table 1. Patients’ characteristics depending on age ≥ 65 years (81 cases ) 19,9% &lt; 65 years (326 cases ) 80,1% Sex-ratio M/F 0,50 0,38 Social coverage Public health assistance scheme 32 (39,5%) 122 (37,42%) Public/Private insurance 21 (25,92%) 91 (27,91%) Without 28 (34,57%) 113 (34,66%) Profession Précisé = 45 Précisé = 162 Without 36 (80%) 104 (64,2%) Retirees 7 (15,55%) 4 (2,47%) Farmer 1 (2,22%) 1 (0,62%) Intermediate professions 1 (2,22%) 18 (11,11%) Higher intellectual professions 0 12 (7,41%) Employees 0 9 (5,55%) Traders and craftsmen 0 9 (5,55%) Workers 0 5 (3,09%) Reason for consultation Back pain 35 (43,2%) 137 (48,15%) Radiculalgia 22 (27,16%) 55 (16,87%) Arthralgias 34 (41,97%) 165 (50,61%) Arthritis 10 (12,34%) 37 (11,35%) Joint involvement Axial 41 (50,61%) 170 (52,15%) Peripheral 53 (65,43%) 248 (76,07%) Duration of symptoms Acute (&lt; 3 weeks) 21 (25,92%) 73 (22,39%) Chronic (≥ 3 weeks) 60 (74,08%) 253 (77,61%) Diagnoses Osteoarthritis 30 (58,82%) 89 (48,9%) Knee osteoarthritis 21 (41,17%) 50 (27,47%) Lumbar osteoarthritis 16 (31,37%) 44 (24,17%) Septic 2 (3,92%) 11 (6,04%) Metabolic 6 (13,35%) 9 (4,94%) Inflammatory 1 (1,96%) 22 (12,08%) Tumor 3 (5,88%) 2 (1,09%) Tendinopathies 3 (9,68%) 29 (15,93%) Treatments Analgesics 47 (71,21%) 155 (63,52%) NSAIDs 19 (28,78%) 118 (48,36%) Corticosteroids 1 (1,51%) 2 (0,82%) Local treatments 18 (27,27%) 72 (29,5%) Symptomatic slow-acting drugs 19 (28,78) 49 (20,08%) DMARDs 0 (0%) 2 (0,82%) Disclosure of Interests: None declared