| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rheumatology 2001; 40: 447-452
© 2001 British Society for Rheumatology
Mortality in rheumatoid arthritis: relationship to single and composite measures of disease activity
Staffordshire Rheumatology Centre, The Haywood, Stoke-on-Trent,
1 Directorate of Public Health, North Staffordshire Health Authority, Stoke-on-Trent and
2 Keele University, Keele, UK
Background. Rheumatoid arthritis (RA) is a heterogeneous disease characterized by a variable course of remissions and relapses. Single measures of disease activity at only one point in time may not reflect the overall control of disease activity.
Objective. The aim was to determine (i) the predictive value of 20 baseline demographic and disease variables on mortality, and (ii) the relationship between serial measures of the Stoke index (SI; a validated index of disease activity in RA) and mortality in RA.
Methods. Mortality in 309 RA patients followed up for a median of 14 yr was analysed retrospectively. The standardized mortality ratio (SMR) was calculated for all causes of death. The predictive values of baseline and time-integrated variables were assessed using multivariate Cox proportional hazards regression analysis.
Results. The SMR was 1.65. At baseline, only nodules, erosions, RA latex titre, white cell count and globulin level were predictive of mortality after correction for age, sex and disease duration. Using a stepwise Cox proportional hazards regression model, the most powerful predictors of mortality were age, nodules and RA latex titre. Individual measures of disease activity and the SI at baseline were not predictive of mortality. However, the mean level of the SI over 12 months was related to mortality (P=0.039).
Conclusions. At baseline, the demographic and disease variables most significantly related to mortality in RA are age, nodules and RA latex titre. Individual measures of disease activity at a single point in time are poor predictors of mortality in RA. However, measurement of the mean level of disease activity over time using the composite SI has a significant relationship with mortality. A high level of sustained inflammation appears to be an important predictor of premature death.
KEY WORDS: Rheumatoid arthritis, Mortality, Stoke index.
Correspondence to: J. C. Chehata, Department of Rheumatology, The Haywood, High Lane, Burslem, Stoke-on-Trent ST6 7AG, UK.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  B. ABELSON, T. SOKKA, and T. PINCUS Declines in Erythrocyte Sedimentation Rates in Patients with Rheumatoid Arthritis Over the Second Half of the 20th Century J Rheumatol, August 1, 2009; 36(8): 1596 - 1599. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Hameed, J. Pilcher, C. Heron, and P. D. W. Kiely The relation between composite ultrasound measures and the DAS28 score, its components and acute phase markers in adult RA Rheumatology, April 1, 2008; 47(4): 476 - 480. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. M Farragher, M. Lunt, D. K Bunn, A. J Silman, and D. P M Symmons Early functional disability predicts both all-cause and cardiovascular mortality in people with inflammatory polyarthritis: results from the Norfolk Arthritis Register Ann Rheum Dis, April 1, 2007; 66(4): 486 - 492. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Young, G. Koduri, M. Batley, E. Kulinskaya, A. Gough, S. Norton, J. Dixey, and on behalf of the Early Rheumatoid Arthritis Study Mortality in rheumatoid arthritis. Increased in the early course of disease, in ischaemic heart disease and in pulmonary fibrosis Rheumatology, February 1, 2007; 46(2): 350 - 357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Kobelt, P. Lindgren, Y. Lindroth, L. Jacobson, and K. Eberhardt Modelling the effect of function and disease activity on costs and quality of life in rheumatoid arthritis Rheumatology, September 1, 2005; 44(9): 1169 - 1175. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D L Mattey, N Nixon, P T Dawes, and J Kerr Association of polymorphism in the transforming growth factor {beta}1 gene with disease outcome and mortality in rheumatoid arthritis Ann Rheum Dis, August 1, 2005; 64(8): 1190 - 1194. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. T. James, C. W. Miller, K. C. Brown, and M. Weaver Pain Disability Among Older Adults With Arthritis J Aging Health, February 1, 2005; 17(1): 56 - 69. [Abstract] [PDF]
|
|
|
|
|
|
N. J. Goodson, A. J. Silman, D. J. Pattison, M. Lunt, D. Bunn, R. Luben, N. Day, K.-T. Khaw, and D. P. M. Symmons Traditional cardiovascular risk factors measured prior to the onset of inflammatory polyarthritis Rheumatology, June 1, 2004; 43(6): 731 - 736. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D. Kitas and N. Erb Tackling ischaemic heart disease in rheumatoid arthritis Rheumatology, May 1, 2003; 42(5): 607 - 613. [Full Text] [PDF]
|
|
|
|
|
|
N Goodson and D Symmons Rheumatoid arthritis in women: still associated with an increased mortality Ann Rheum Dis, November 1, 2002; 61(11): 955 - 956. [Full Text] [PDF]
|
|
|
|
|
|
T R Mikuls, K G Saag, L A Criswell, L A Merlino, R A Kaslow, B J Shelton, and J R Cerhan Mortality risk associated with rheumatoid arthritis in a prospective cohort of older women: results from the Iowa Women's Health Study Ann Rheum Dis, November 1, 2002; 61(11): 994 - 999. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Grove, J. C. Chehata, P. W. Jones, D. L. Mattey, and P. T. Dawes Re: Chehata et al. Mortality in rheumatoid arthritis: relationship to single and composite measures of disease activity Rheumatology, June 1, 2002; 41(6): 701 - 701. [Full Text] [PDF]
|
|