Rate ratios* and 95% CIs for pneumococcal disease in people with selected immune-mediated diseases compared with the control cohort†
| Immune-mediated disease (ICD code‡) | Data set (years) | ||
| ORLS1 (1963–1998), rate ratio (95% CI) | ORLS2 (1999–2008), rate ratio (95% CI) | England (1999–2008), rate ratio (95% CI) | |
| Addison's disease (E27.1) | 3.54 (1.70 to 6.52) | 3.49 (1.74 to 6.25) | 3.78 (3.40 to 4.20) |
| Ankylosing spondylitis (M45) | 1.41 (0.64 to 2.68) | 1.96 (1.07 to 3.30) | 2.53 (2.32 to 2.75) |
| Autoimmune haemolytic anaemia (D59.1) | 4.46 (1.92 to 8.81) | 5.98 (3.59 to 9.37) | 4.86 (4.42 to 5.34) |
| Chronic active hepatitis (K73.2) | 3.65 (1.47 to 7.53) | 2.19 (0.71 to 5.13) | 3.50 (2.95 to 4.13) |
| Crohn's disease (K50) | 1.67 (1.12 to 2.41) | 2.37 (1.85 to 2.99) | 2.25 (2.14 to 2.35) |
| Dermatomyositis, polymyositis (M33) | 3.09 (1.13 to 6.73) | 2.22 (0.72 to 5.18) | 3.90 (3.36 to 4.50) |
| Diabetes mellitus§ (E10–E14) | 2.20 (1.38 to 3.34) | 3.30 (2.07 to 5.07) | 3.90 (3.55 to 4.28) |
| Idiopathic thrombocytopaenia purpura (D69.3) | 1.64 (0.66 to 3.39) | 3.51 (2.38 to 4.99) | 2.48 (2.28 to 2.68) |
| Multiple sclerosis (G35) | 3.71 (2.83 to 4.80) | 4.15 (3.30 to 5.15) | 3.67 (3.50 to 3.83) |
| Myasthenia gravis (G70.0) | 1.75 (0.57 to 4.10) | 4.85 (3.00 to 7.44) | 2.18 (1.95 to 2.45) |
| Myxoedema (E03.8–E03.9) | 2.09 (1.73 to 2.50) | 1.68 (1.51 to 1.86) | 1.61 (1.58 to 1.64) |
| Pemphigus, pemphigoid (L10+L12) | 1.52 (0.69 to 2.89) | 2.52 (1.46 to 4.04) | 2.13 (1.94 to 2.33) |
| Pernicious anaemia (D51.0) | 2.05 (1.65 to 2.51) | 1.65 (1.16 to 2.28) | 1.75 (1.67 to 1.83) |
| Polyarteritis nodosa (M30.0) | 3.11 (1.01 to 7.27) | 3.63 (1.18 to 8.48) | 4.97 (4.05 to 6.03) |
| Primary biliary cirrhosis (K74.3) | 4.10 (1.77 to 8.10) | 3.83 (1.75 to 7.28) | 3.32 (2.95 to 3.73) |
| Psoriasis (L40) | 1.54 (1.06 to 2.17) | 1.96 (1.46 to 2.58) | 2.06 (1.96 to 2.15) |
| Rheumatoid arthritis (M05–M06) | 2.35 (2.06 to 2.66) | 2.46 (2.18 to 2.77) | 2.48 (2.42 to 2.53) |
| Scleroderma (M34) | 5.77 (2.63 to 11.0) | 4.97 (3.07 to 7.62) | 4.26 (3.84 to 4.72) |
| Sjogren's syndrome (M35.0) | 4.34 (1.41 to 10.2) | 2.60 (1.24 to 4.79) | 3.17 (2.89 to 3.48) |
| Systemic lupus erythematosus (M32.1–M32.9) | 8.97 (5.61 to 13.6) | 4.48 (2.84 to 6.74) | 5.01 (4.64 to 5.40) |
| Thyrotoxicosis (E05) | 1.21 (0.92 to 1.58) | 1.77 (1.38 to 2.25) | 1.92 (1.84 to 2.00) |
| Ulcerative colitis (K51) | 1.34 (0.97 to 1.81) | 1.90 (1.55 to 2.30) | 1.70 (1.63 to 1.77) |
↵* Adjusted for sex, age in 5-year bands, time period in single calendar years and district of residence in the ORLS data sets; and for sex, age in 5-year bands, time period in single calendar years, region of residence and deprivation score associated with patients' area of residence, in quintiles, in the England data set. The rate ratios are calculated as the ratio of the observed/expected number in the cohort for each immune-mediated disease (see appendix 1, online only) to the observed/expected numbers in the reference cohort as calculated in the analysis undertaken for each of the individual disease (data not shown).
↵† Conditions used in reference cohort, with Office of Population, Censuses and Surveys (OPCS) code edition 3 for operations and ICD10 code for diagnosis (with equivalent codes used for other coding editions): appendicectomy (OPCS3 441), hip replacement (810), knee replacement (820), squint (ICD10 H49–H51), varicose veins (I83), haemorrhoids (I84), deflected septum, nasal polyp (J33+J34.2), impacted tooth and other disorders of teeth (K00–K03), inguinal hernia (K40), ingrowing toenail and other diseases of nail (L60), sebaceous cyst (L72.1), internal derangement of knee (M23), bunion (M20.1), selected fractures (S42, S52, S62, S82, S92), dislocations, sprains and strains (S03, S13, S23, S33, S43, S53, S63, S73, S83, S93) and superficial injury and contusion (S00, S10, S20, S30, S40, S50, S60, S70, S80, S90).
↵‡ ICD 10 codes for each immune-mediated disease (equivalent codes were used for cases coded in ICD revisions 7, 8 and 9).
↵§ Analysis confined to people recorded as having diabetes mellitus when aged younger than 30 years.
ICD=International Classification of Diseases.