Patients with comorbid rheumatoid arthritis are predisposed to peritonsillar abscess: real-world evidence

European Archives of Oto-Rhino-Laryngology (2021)Cite this article

Abstract

Purpose

The peritonsillar abscess (PTA)–rheumatoid arthritis (RA) association remains unclear. Here, the effects of RA on PTA incidence and prognosis are elucidated.

Methods

We compared PTA incidence and prognosis of 30,706 RFCIP-registered patients with RA (RA cohort) with matched individuals without RA from another database of 1 million randomly selected people representing Taiwan’s population (non-RA cohort).

Results

The RA cohort had significantly higher PTA incidence [incidence rate ratio (IRR) (95% CI) 1.73 (1.10–2.71), P = 0.017) and cumulative incidence (P = 0.016, Kaplan–Meier curves). Cox regression analyses demonstrated RA cohort to have an estimated 1.72-fold increased PTA risk (95% CI 1.09–2.69, P = 0.019). PTA was more likely within the first 5 years of RA diagnosis (for < 1, 1–5, and ≥ 5 postdiagnosis years, IRRs: 2.67, 2.31, and 1.10, respectively, and P = 0.063, 0.021, and 0.794, respectively; average onset duration: 4.3 ± 3.3 years after RA diagnosis). PTA increased length of hospital stay significantly and risk of complication with deep neck infection nonsignificantly [6.5 ± 4.5 vs 4.6 ± 2.8 days (P = 0.045) and 18.52% vs 7.81% (P = 0.155), respectively]. Moreover, RA-cohort patients not receiving RA therapy exhibited 5.06-fold higher PTA risk than those receiving RA-related therapy (95% CI 1.75–14.62, P = 0.003).

Conclusions

In patients with RA, PTA incidence is the highest within 5 years of RA diagnosis, and RA therapy is essential for reducing PTA risk.

Level of evidence

4.

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Acknowledgments

We extend our gratitude to Chiayi Chang Gung Memorial Hospital’s Health Information and Epidemiology Laboratory for providing valuable comments and assistance in our data analysis. This manuscript was edited by Wallace Academic Editing.

Funding

The study was financially supported by grants from the Chang Gung Memorial Hospital, Taiwan (CGRPG6G0021).

Author information

Affiliations

  1. Department of Otolaryngology–Head and Neck Surgery, Chang Gung Memorial Hospital, 6, W. Sec., Jiapu Rd., Puzih, Chiayi County, 613, Taiwan

    Meng-Chang Ding, Ming-Shao Tsai, Yao-Te Tsai, Cheng-Ming Hsu, Ching-Yuan Wu & Geng-He Chang

  2. Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Ming-Shao Tsai, Yao-Hsu Yang, Chia-Yen Liu, Yao-Te Tsai & Geng-He Chang

  3. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University At Taoyuan, Taoyuan, Taiwan

    Ming-Shao Tsai, Cheng-Ming Hsu, Ching-Yuan Wu, Pey-Jium Chang, Ko-Ming Lin & Geng-He Chang

  4. Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Ming-Shao Tsai, Yao-Te Tsai, Cheng-Ming Hsu, Ko-Ming Lin & Geng-He Chang

  5. Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Yao-Hsu Yang & Ching-Yuan Wu

  6. School of Traditional Chinese Medicine, College of Medicine, Chang Gung University At Taoyuan, Taoyuan, Taiwan

    Yao-Hsu Yang & Ching-Yuan Wu

  7. Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Ko-Ming Lin

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  1. Meng-Chang Ding
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Contributions

Meng-Chang Ding: study execution, article completion, Ming-Shao Tsai: study conception, study design, data interpretation, article draft, Yao-Hsu Yang: study execution, data acquisition, data analysis, Chia-Yen Liu: study execution, data analysis, figure charting, table making, Yao-Te Tsai: study conception, study design, data interpretation, article draft, Cheng-Ming Hsu: study conception, study design, data interpretation, article draft, Ching-Yuan Wu: study conception, study design, data interpretation, article draft, Pey-Jium Chang: study conception, study design, data interpretation, article draft, Ko-Ming Lin: study conception, study design, data interpretation, article draft, Geng-He Chang: study conception, study design, study execution, data interpretation, figure and table revision, critical article revision, final approval for submission.

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Correspondence to Geng-He Chang.

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Ding, MC., Tsai, MS., Yang, YH. et al. Patients with comorbid rheumatoid arthritis are predisposed to peritonsillar abscess: real-world evidence. Eur Arch Otorhinolaryngol (2021). https://doi.org/10.1007/s00405-021-06638-3

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Keywords

  • Cervical abscess
  • Cervical cellulitis
  • Autoimmune
  • Risk factor
  • Nationwide database
  • National health insurance research database