POS0012 EPIDEMIOLOGY OF FIBROMYALGIA HOSPITALIZATIONS IN THE UNITED STATES
Authors: K. Mathias, A. Mantha, L. Mathias, D. Arkfeld
Journal: Annals of the Rheumatic Diseases (2021)

Background: Fibromyalgia is a chronic pain syndrome that is associated with protean symptoms including musculoskeletal pain, psychiatric symptoms, cognitive dysfunction, memory difficulty, and sleep disturbance. Fibromyalgia can be a primary diagnosis, or it can be associated with other conditions. Fibromyalgia is often seen in conjunction with autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. In 1990, the American College of Rheumatology released classification criteria for fibromyalgia that included symptoms of diffuse pain and physical exam findings of at least 11 of 18 defined tender points. In 2010, the ACR updated these criteria and eliminated the requirement of tender points. In 2011, these criteria were further modified to that they could be self-administered. A previous study used the national inpatient sample to examine hospitalization data for patients with fibromyalgia from 1999-2007. 1 No studies, however, have examined this data since the new ACR criteria were established in 2010. Objectives: We aim to characterize the epidemiology of hospitalized patients with diagnosis of fibromyalgia. Methods: Hospitalized patients with a diagnosis of fibromyalgia were identified in the 2016-2018 National Inpatient Sample (NIS) using the International Classification of Diseases 10 system (ICD-10). The NIS is an all-payer inpatient database that estimates over 37 million annual U.S. hospitalizations and is maintained by the Healthcare Cost and Utilization Project. The primary outcomes were prevalence of fibromyalgia and comorbid rheumatologic conditions among hospitalized patients. Secondary outcomes included cause of admission, mortality, length of stay, and cost of care. Results: Of 1,351,234 patients with fibromyalgia identified, 437,145 were admitted in 2016 increasing to 461,820 in 2018. On average 59.1 years old, more likely female (1,262,735, 93.5%) and white (1,060,845, 81.3%). Patients were most likely to have Medicare (775,420, 57.5%) and were in the bottom quartile of income (402,945, 30.3%). The most common rheumatologic comorbidities were rheumatoid arthritis (142,195, 10.5%), lupus (69,980, 5.2%), and inflammatory bowel disease (38,165, 2.2%). Notably fibromyalgia was commonly associated with depression (500,420, 37.0%), obesity (379,324, 28.1%), hypothyroidism (334,585 24.7%), and congestive heart failure (213,790, 15.8%).The mortality rate was 13,605 (1.0%) patients, the average length of stay was (4.53 days), and the average cost of hospitalization ($12,522). The most common causes of admission were inflammatory syndromes and joint disorders (13.4%) of which OA (4.2%) was most common complaint, digestive complaints (12.1%) of which IBD (4.4%) was most common. Conclusion: The yearly number of fibromyalgia hospital discharges were greater than previously described. This may be a result of a more sensitive classification criteria. Further investigation into the etiology of this increase in fibromyalgia hospitalization diagnosis is warranted. References: [1]Haviland MG, Banta JE, Przekop P. Fibromyalgia: prevalence, course, and co-morbidities in hospitalized patients in the United States, 1999-2007. Clin Exp Rheumatol. 2011 Nov-Dec;29(6 Suppl 69):S79-87. Epub 2012 Jan 3. PMID: 22243553. Disclosure of Interests: None declared.