{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:59:16Z","timestamp":1790672356817,"version":"4.1.0"},"reference-count":0,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Hospitalization, particularly for surgery, represents a period of heightened stress. We evaluated how frailty attenuates the association of rheumatoid arthritis (RA) with negative health outcomes after elective non\u2010cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional study using the National Inpatient Sample (2018 to 2020), including adults (\u226518 years) with elective hospitalizations with non\u2010cardiac surgery. Frailty was measured using the Hospital Frailty Risk Score (HFRS). Surgeries were categorized by risk level. Outcomes included discharge health resources need (DHRN), composite adverse clinical events (CACE), and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 8,800,359 hospitalizations (RA, 2.14%), 73.36% underwent intermediate risk surgery, 62.25% had HFRS &gt; 0. DHRN occurred in 28.9%, CACE in 0.93%, all\u2010cause mortality in 0.17%. Ten\u2010point increase in HFRS was associated with 3.8\u2010fold increased DHRN, 8.5\u2010fold increased CACE, and 22.8\u2010fold increased mortality. RA was not independently associated with CACE (adjusted Odds Ratio [aOR], 0.91; 95% CI, 0.82, 1.01; p=0.08), or mortality (aOR, 0.90; 95% CI, 0.71 to 1.15; p=0.41) but significantly associated with DHRN (aOR, 1.28, 1.25 to 1.31; p&lt;0.001) after adjusting for confounders and frailty. In sensitivity analysis, RA had 10% higher relative odds of DHRN following orthopedic (aOR, 1.10; 95% CI, 1.07, 1.13; p&lt;0.001) but not non\u2010orthopedic intermediate risk surgery (aOR, 1.10; 95% CI, 0.98, 1.23; p=0.11).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>RA was associated with a higher odds of DHRN after orthopedic intermediate risk surgery but not CACE or inpatient mortality. Moreover, HFRS was associated with DHRN, CACE, and mortality. These findings underscore the need for disease\u2010specific clinical considerations and highlight the potential utility of HFRS in discharge planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80171","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:03:52Z","timestamp":1790669032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rheumatoid arthritis, frailty, and outcomes of surgical hospitalizations: A national population\u2010based analysis"],"prefix":"10.1002","author":[{"given":"Ali","family":"Yazdanyar","sequence":"first","affiliation":[{"name":"University of Pennsylvania  Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-7563","authenticated-orcid":false,"given":"Joshua","family":"Baker","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia PA"},{"name":"Corporal Crescenz VA Medical Center  Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8707-7649","authenticated-orcid":false,"given":"Katherine D","family":"Wysham","sequence":"additional","affiliation":[{"name":"University of Washington  Seattle WA"},{"name":"VA Puget Sound Health Care System  Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Yousufuddin","sequence":"additional","affiliation":[{"name":"Mayo Clinic Health System  Austin MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Acher","family":"Kaiksow","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Ward","sequence":"additional","affiliation":[{"name":"Verier Outcomes Research  Rockville MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80171","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:03:53Z","timestamp":1790669033000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.80171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":0,"alternative-id":["10.1002\/acr.80171"],"URL":"https:\/\/doi.org\/10.1002\/acr.80171","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2025-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"acr.80171"}}