Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1999 Jan;58(1):11–14. doi: 10.1136/ard.58.1.11

Mortality in rheumatoid arthritis patients with disease onset in the 1980s

E Lindqvist 1, K Eberhardt 1
PMCID: PMC1752757  PMID: 10343534

Abstract

OBJECTIVE—Several previous studies have shown increased mortality in rheumatoid arthritis (RA) patients. This study investigated if this was true also for patients with disease onset in the 1980s.
PATIENTS AND METHODS—The study group comprised 183 patients (67 men and 116 women) with definite RA participating in an ongoing prospective study. Mean age at onset of disease was 51 years, and mean duration of joint symptoms at inclusion was 11 months. The patients were included between 1985-89. Seventy five per cent of the patients were rheumatoid factor (RF) positive, 85% carried the shared epitope, and 90% became erosive. By 1 September 1997 the number and causes of death, obtained from the death certificates, were recorded. Standardised mortality ratio (SMR) was calculated, comparing the observed number of deaths in the cohort with the expected number of deaths in the general population in the same area, age and sex matched. The predictive values of demographics, genotype, RF status, and clinical data at baseline were estimated using the Cox proportional hazards regression model.
RESULTS—Eighteen patients (11 men and 7 women) had died compared with 20 expected deaths. SMR with 95% confidence intervals was 87 (53, 136). There was no significant increase in the number of deaths at any time during follow up for either sex. RA was not the main cause of death in any of the cases. By reading the patient charts two cases were found where RA or its treatment could have contributed to death. No RA related variable contributed significantly to an increased risk of death.
CONCLUSION—There was no increased mortality during the first 8-13 years of disease in this group of patients who developed RA in the 1980s.

 Keywords: rheumatoid arthritis; mortality; causes of death; prognosis

Full Text

The Full Text of this article is available as a PDF (95.8 KB).

Figure 1  .

Figure 1  

Number of deaths in the cohort of RA patients, compared with the expected number of deaths in the age and sex matched, general population of Malmöhus County. The number of patients followed up each year are shown under the curve.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. COBB S., ANDERSON F., BAUER W. Length of life and cause of death in rheumatoid arthritis. N Engl J Med. 1953 Oct 1;249(14):553–556. doi: 10.1056/NEJM195310012491402. [DOI] [PubMed] [Google Scholar]
  2. Corbett M., Dalton S., Young A., Silman A., Shipley M. Factors predicting death, survival and functional outcome in a prospective study of early rheumatoid disease over fifteen years. Br J Rheumatol. 1993 Aug;32(8):717–723. doi: 10.1093/rheumatology/32.8.717. [DOI] [PubMed] [Google Scholar]
  3. DIAGNOSTIC criteria for rheumatoid arthritis: 1958 revision by a committee of the American Rheumatism Association. Ann Rheum Dis. 1959 Mar;18(1):49–53. [PMC free article] [PubMed] [Google Scholar]
  4. Eberhardt K. B., Fex E. Functional impairment and disability in early rheumatoid arthritis--development over 5 years. J Rheumatol. 1995 Jun;22(6):1037–1042. [PubMed] [Google Scholar]
  5. Eberhardt K. B., Rydgren L. C., Pettersson H., Wollheim F. A. Early rheumatoid arthritis--onset, course, and outcome over 2 years. Rheumatol Int. 1990;10(4):135–142. doi: 10.1007/BF02274837. [DOI] [PubMed] [Google Scholar]
  6. Eberhardt K., Fex E., Johnson U., Wollheim F. A. Associations of HLA-DRB and -DQB genes with two and five year outcome in rheumatoid arthritis. Ann Rheum Dis. 1996 Jan;55(1):34–39. doi: 10.1136/ard.55.1.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ekdahl C., Eberhardt K., Andersson S. I., Svensson B. Assessing disability in patients with rheumatoid arthritis. Use of a Swedish version of the Stanford Health Assessment Questionnaire. Scand J Rheumatol. 1988;17(4):263–271. doi: 10.3109/03009748809098795. [DOI] [PubMed] [Google Scholar]
  8. Fex E., Jonsson K., Johnson U., Eberhardt K. Development of radiographic damage during the first 5-6 yr of rheumatoid arthritis. A prospective follow-up study of a Swedish cohort. Br J Rheumatol. 1996 Nov;35(11):1106–1115. doi: 10.1093/rheumatology/35.11.1106. [DOI] [PubMed] [Google Scholar]
  9. Jacobsson L. T., Knowler W. C., Pillemer S., Hanson R. L., Pettitt D. J., Nelson R. G., del Puente A., McCance D. R., Charles M. A., Bennett P. H. Rheumatoid arthritis and mortality. A longitudinal study in Pima Indians. Arthritis Rheum. 1993 Aug;36(8):1045–1053. doi: 10.1002/art.1780360804. [DOI] [PubMed] [Google Scholar]
  10. Jacoby R. K., Jayson M. I., Cosh J. A. Onset, early stages, and prognosis of rheumatoid arthritis: a clinical study of 100 patients with 11-year follow-up. Br Med J. 1973 Apr 14;2(5858):96–100. doi: 10.1136/bmj.2.5858.96. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Larsen A., Dale K., Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977 Jul;18(4):481–491. doi: 10.1177/028418517701800415. [DOI] [PubMed] [Google Scholar]
  12. Mitchell D. M., Spitz P. W., Young D. Y., Bloch D. A., McShane D. J., Fries J. F. Survival, prognosis, and causes of death in rheumatoid arthritis. Arthritis Rheum. 1986 Jun;29(6):706–714. doi: 10.1002/art.1780290602. [DOI] [PubMed] [Google Scholar]
  13. Pincus T., Brooks R. H., Callahan L. F. Prediction of long-term mortality in patients with rheumatoid arthritis according to simple questionnaire and joint count measures. Ann Intern Med. 1994 Jan 1;120(1):26–34. doi: 10.7326/0003-4819-120-1-199401010-00005. [DOI] [PubMed] [Google Scholar]
  14. Prior P., Symmons D. P., Scott D. L., Brown R., Hawkins C. F. Cause of death in rheumatoid arthritis. Br J Rheumatol. 1984 May;23(2):92–99. doi: 10.1093/rheumatology/23.2.92. [DOI] [PubMed] [Google Scholar]
  15. Reilly P. A., Cosh J. A., Maddison P. J., Rasker J. J., Silman A. J. Mortality and survival in rheumatoid arthritis: a 25 year prospective study of 100 patients. Ann Rheum Dis. 1990 Jun;49(6):363–369. doi: 10.1136/ard.49.6.363. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Silman A. J. Are there secular trends in the occurrence and severity of rheumatoid arthritis? Scand J Rheumatol Suppl. 1989;79:25–30. doi: 10.3109/03009748909092609. [DOI] [PubMed] [Google Scholar]
  17. Symmons D. P. Mortality in rheumatoid arthritis. Br J Rheumatol. 1988;27 (Suppl 1):44–54. [PubMed] [Google Scholar]
  18. Truedsson L., Sjöholm A. G., Sturfelt G. Complement activating rheumatoid factors in rheumatoid arthritis studied by haemolysis in gel: relation to antibody class and response to treatment with podophyllotoxin derivatives. Clin Exp Rheumatol. 1985 Jan-Mar;3(1):29–37. [PubMed] [Google Scholar]
  19. Vandenbroucke J. P., Hazevoet H. M., Cats A. Survival and cause of death in rheumatoid arthritis: a 25-year prospective followup. J Rheumatol. 1984 Apr;11(2):158–161. [PubMed] [Google Scholar]
  20. Wolfe F., Mitchell D. M., Sibley J. T., Fries J. F., Bloch D. A., Williams C. A., Spitz P. W., Haga M., Kleinheksel S. M., Cathey M. A. The mortality of rheumatoid arthritis. Arthritis Rheum. 1994 Apr;37(4):481–494. doi: 10.1002/art.1780370408. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES