THE MORTALITY OF RHEUMATOID-ARTHRITIS
THE MORTALITY OF RHEUMATOID-ARTHRITIS
复制标题
DOI：
10.1002/art.1780370408
复制
发表时间：
1994-04-01
影响因子：
--
通讯作者：
CATHEY, MA
中科院分区：
文献类型：
--
作者：
WOLFE, F;MITCHELL, DM;CATHEY, MA
客观的。确定类风湿性关节炎 (RA) 患者的死亡风险和原因并量化死亡预测因子。方法。对来自 4 个中心（萨斯卡通 n = 905、威奇托 n = 1,405、斯坦福大学 n = 886 和圣克拉拉 n = 305）的 RA 患者 (n = 3,501) 进行了长达 35 年的随访； 922 名患者死亡。结果。总体标准化死亡率 (SMR) 为 2.26（萨斯卡通 2.24、威奇托 1.98、斯坦福 3.08、圣克拉拉 2.18），并且随着时间的推移而增加。特定原因的死亡率显着增加：感染、淋巴增殖性恶性肿瘤、胃肠病和类风湿性关节炎。此外，由于 SMR 为 2.26，所有原因（癌症除外）的预期死亡人数均出现非特异性增加，其中心脑血管疾病导致的死亡人数大幅增加。死亡率的独立预测因素包括年龄、教育程度、男性、功能、类风湿因子、结节、红细胞沉降率、关节计数和泼尼松使用。结论。 RA 的死亡率至少增加 2 倍，并且与临床严重程度相关。
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.Conclusion. Mortality rates are increased at least 2-fold in RA, and are linked to clinical severity.