Decreased in-hospital mortality in shock patients with rheumatoid arthritis compared to those without: a retrospective analysis of a critical care database

Inflammatory response is a natural protective response in infection or injury. The immune imbalance of rheumatoid arthritis (RA) patients and the use of anti-rheumatic immune drugs may affect the inflammatory response process of shock. The evidence of the impact of RA on short-time mortality in shock patients is limited. This study was a retrospective observational study from the Medical Information Mart for Intensive Care IV database (MIMIC-IV). Patients diagnosed with shock were selected from the database. The primary outcome was in-hospital mortality. Binary logistic regression analysis was used to explore the association between RA and in-hospital mortality. Subgroup analysis of the association between in-hospital mortality and RA was performed in septic shock, cardiogenic shock, and other types of shock. A total of 8233 ICU patients with shock were identified. After adjusting for confounding variables, RA was associated with a lower risk of in-hospital mortality (OR, 0.58; 95% CI, 0.38–0.91). The results of the subgroup analysis showed that RA was associated with a decreased risk of in-hospital death in the septic shock group but not in cardiogenic shock or other types of shock. RA was associated with a lower risk of in-hospital death in shock patients. This association was only observed in septic shock but not in cardiogenic shock and other types of shock.