The mortality of rheumatoid arthritis

Objective. To determine the risk and causes of death and to quantify mortality predictors in patients with rheumatoid arthritis (RA). Methods. RA patients (n = 3,501) from 4 centers (Saskatoon n = 905, Wichita n = 1,405, Stanford n = 886, and Santa Clara n = 305) were followed for up to 35 years; 92...

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Bibliographic Details
Published in:Arthritis and rheumatism 1994-12, Vol.37 (4), p.481-494
Main Authors: Wolfe, Frederick, Mitchell, Donald M., Sibley, John T., Fries, James F., Bloch, Daniel A., Williams, Catherine A., Spitz, Patricia W., Haga, May, Kleinheksel, Sue M., Cathey, Mary Ann
Format: Article
Language:English
Subjects:
Arthritis, Rheumatoid - mortality
Biological and medical sciences
California - epidemiology
Cause of Death
Databases, Factual
Diseases of the osteoarticular system
Female
Follow-Up Studies
Humans
Inflammatory joint diseases
Kansas - epidemiology
Male
Medical sciences
Middle Aged
Prospective Studies
Risk Factors
Saskatchewan - epidemiology
Survival Rate
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Summary:Objective. To determine the risk and causes of death and to quantify mortality predictors in patients with rheumatoid arthritis (RA). Methods. RA patients (n = 3,501) from 4 centers (Saskatoon n = 905, Wichita n = 1,405, Stanford n = 886, and Santa Clara n = 305) were followed for up to 35 years; 922 patients died. Results. The overall standardized mortality ratio (SMR) was 2.26 (Saskatoon 2.24, Wichita 1.98, Stanford 3.08, Santa Clara 2.18) and increased with time. Mortality was strikingly increased for specific causes: infection, lymphoproliferative malignancy, gastroenterologic, and RA. In addition, as an effect of the SMR of 2.26, the expected number of deaths was increased nonspecifically across all causes (except cancer), with a large excess of deaths attributable to cardiovascular and cerebrovascular diseases. Independent predictors of mortality included age, education, male sex, function, rheumatoid factor, nodules, erythrocyte sedimentation rate, joint count, and prednisone use.
ISSN:0004-3591
1529-0131
DOI:10.1002/art.1780370408