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Rheumatol Int. 2017 Apr;37(4):487-493. doi: 10.1007/s00296-016-3638-5. Epub 2016 Dec 28.

Mortality in patients with rheumatoid arthritis: a 15-year prospective cohort study.

Author information

1
Amsterdam Rehabilitation Research Center | Reade, PO Box 58271, 1040, HG, Amsterdam, The Netherlands. j.vd.hoek@reade.nl.
2
Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. j.vd.hoek@reade.nl.
3
National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
4
Biometrics, Wageningen University and Research Centre, Wageningen, The Netherlands.
5
Amsterdam Rehabilitation Research Center | Reade, PO Box 58271, 1040, HG, Amsterdam, The Netherlands.
6
Amsterdam Rheumatology and Immunology Center, Location Reade, Amsterdam, The Netherlands.
7
Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
8
Departments of Rehabilitation and Psychiatry, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.

Abstract

The aim of this study was to investigate (a) the mortality in a clinical cohort of patients with established rheumatoid arthritis in comparison with the general Dutch population over 15 years, (b) the trend in the mortality ratio during the study period, and (c) causes of death and compare these with the general population. In 1997, a sample of 1222 patients was randomly selected from the register of a large rheumatology outpatient clinic. Their mortality and primary causes of death between 1997 and 2012 were obtained from Statistics Netherlands. The standardized mortality ratio (SMR) for all-cause mortality and the number of life-years lost in the study period, adjusted for age, sex, and calendar year, were calculated. A linear poisson regression analysis was performed to evaluate change in all-cause SMR over time. Finally, the SMRs for cause-specific mortality were calculated. The mean age of the population at baseline was 60.4 (SD 15.4) years, and 72.6% of the patients were women. The estimated SMR (95% CI) for all-cause mortality was 1.54 (1.41, 1.67) with about one life-year lost over the study period. There was a trend to decreasing SMR (2% annually, p = .07). Mortality was higher compared with the general population for circulatory system diseases, respiratory system diseases, musculoskeletal system diseases, and digestive system diseases (p < .05). The observed mortality among patients with RA was 54% higher than in the general population after adjustment for age, sex and calendar year. More than one life-year was lost over 15 years, and the mortality tended to decrease over time. The mortality was higher for cardiovascular, respiratory, musculoskeletal and digestive diseases.

KEYWORDS:

Cause of death; Cohort study; Comorbidity; Longitudinal studies; Mortality; Rheumatoid arthritis; Survival

PMID:
28032180
PMCID:
PMC5357293
DOI:
10.1007/s00296-016-3638-5
[Indexed for MEDLINE]
Free PMC Article

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