Patients with rheumatoid arthritis (RA) have reduced life expectancy ; however, there are few data on the changing pattern of causes of death with longterm followup, or on the longterm effect of early presentation.
The objectives of this study were (I) to examine the effect of early presentation on subsequent mortality ; (2) to compare the causes of death early and late in the followup period ; and (3) to compare survival of the cohort with that of the general population (adjusted for age and sex) over a followup period of up to 27 years.
A cohort of 448 patients with RA (inpatients and outpatients), assembled 1968-74, were followed to December 31,1990.
Death certificates were obtained for all who had died and coded using the International Classification of Diseases.
Kaplan-Meier survival curves were constructed.
By the end of the study, 266 patients (59%) had died.
The standardized mortality ratio (SMR) was 2.7 (95% CI 2.4-3.1).
Patients who presented early continued to do well.
Most excess deaths were due to cardiovascular disease.
SMR due to infection, renal failure, and non-Hodgkin's lymphoma rose with disease duration.
Patients with RA should be referred early, and those with chronic disease should be closely monitored for evidence of infection and renal impairment.
Mots-clés Pascal : Polyarthrite rhumatoïde, Pronostic, Long terme, Epidémiologie, Mortalité, Etiologie, Homme, Chronique, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune
Mots-clés Pascal anglais : Rheumatoid arthritis, Prognosis, Long term, Epidemiology, Mortality, Etiology, Human, Chronic, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0311399
Code Inist : 002B15D. Création : 27/11/1998.