{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:20:42Z","timestamp":1789039242107,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T00:00:00Z","timestamp":1493337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["T32\u2010AR007258"],"award-info":[{"award-number":["T32\u2010AR007258"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Granulomatosis with polyangiitis (Wegener's) (GPA) is a type of antineutrophil cytoplasmic antibody\u2013associated vasculitis that often entails severe end\u2010organ damage and treatment\u2010related complications that frequently lead to hospitalization and death. Nationwide trends in hospitalizations and in\u2010hospital mortality over the past 2 decades are unknown and were evaluated in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the National Inpatient Sample, the largest all\u2010payer inpatient database in the US, trends in hospitalizations with a discharge diagnosis of GPA (formerly Wegener's granulomatosis; International Classification of Disease, Ninth Revision, Clinical Modification code 446.4) between 1993 and 2011 were studied. Analyses were performed using hospital\u2010level sampling weights to obtain US national estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1993 to 2011, the annual hospitalization rate for patients with a principal diagnosis of GPA increased by 24%, from 5.1 to 6.3 per 1 million US persons (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 for trend); however, in\u2010hospital deaths in this group declined by 73%, from 9.1% to 2.5% (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 for trend), resulting in a 66% net reduction in the annual in\u2010hospital mortality rate. The median length of stay declined by 20%, from 6.9 days in 1993 to 5.5 days in 2011 (<jats:italic>P<\/jats:italic>\u2009=\u20090.0002 for trend). Infection was the most common principal discharge diagnosis when GPA was a secondary diagnosis, including among those who died during hospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings from these nationally representative, contemporary inpatient data indicate that the in\u2010hospital mortality of GPA has declined substantially over the past 2 decades, while the overall hospitalization rate for GPA increased slightly. Infection remains a common principal hospitalization diagnosis among GPA patients, including hospitalizations resulting in mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22976","type":"journal-article","created":{"date-parts":[[2016,7,7]],"date-time":"2016-07-07T11:17:45Z","timestamp":1467890265000},"page":"915-921","source":"Crossref","is-referenced-by-count":35,"title":["Nationwide Trends in Hospitalizations and In\u2010Hospital Mortality in Granulomatosis With Polyangiitis (Wegener's)"],"prefix":"10.1002","volume":"69","author":[{"given":"Zachary S.","family":"Wallace","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Lu","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Miloslavsky","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Unizony","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Stone","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyon K.","family":"Choi","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,28]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390112"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq351"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24957"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-116-6-488"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar771"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02890806"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-0352"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.07.009"},{"key":"e_1_2_3_10_1","article-title":"Trends in gout and rheumatoid arthritis hospitalizations in the United States, 1993\u20132011","author":"Lim S","journal-title":"JAMA"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909905"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.384"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv045"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2064"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1518"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150186"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.22976","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.22976","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.22976","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:28:10Z","timestamp":1759418890000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.22976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,28]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1002\/acr.22976"],"URL":"https:\/\/doi.org\/10.1002\/acr.22976","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,28]]}}}