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How many life years are lost in patients with rheumatoid arthritis? Secular cause-specific and all-cause mortality in rheumatoid arthritis, and their predictors in a long-term Australian cohort study.
Intern Med J. 2013 Jan; 43(1):66-72.IM

Abstract

BACKGROUND

There is an excess of mortality in patients with rheumatoid arthritis (RA) but no long-term Australian cohort data.

AIMS

To determine median life years lost, all-cause standardised mortality ratio (SMR) and cause-specific SMR, their predictors and secular change in Australian patients with RA.

METHODS

Study population was all patients seen by a rheumatologist between 1990 and 1994. Record linkage with Australian National Death Index was performed to determine fact and cause of death up to 2004. All-cause and cause-specific SMR, and median life years lost were determined.

RESULTS

There were 35 (31%) deaths in the early 1990s cohort (n = 113), SMR 1.31 (95% 0.93, 1.80). There were 216 (44%) deaths in the pre-1990s established cohort (n = 495), SMR 1.73 (1.49, 1.95). Median life years lost in the early cohort was 6 years for males and 7 years for females compared with 8 and 10 years, respectively, in the established cohort. Patients with low disease activity score at baseline (DAS < 3.2), SMR was 0.8 (0.3, 2.2) and 1.5 (1.1, 2.2) for the early and established cohorts, and if DAS ≥3.2, SMR was 1.4 (1.02, 1.98) and 1.8 (1.5, 2.1) respectively. Primary cause of death was cardiovascular disease (SMR 1.43 (1.17, 1.74). Patients at most risk were those age 45-54 years. RA was listed as a comorbid condition on the death certificate in only 16% of patients.

CONCLUSIONS

Within a period of 14 years, median life expectancy of patients with RA with disease onset in the early 1990s is reduced by 6-7 years. However, our results also suggest a secular reduction in excess mortality.

Authors+Show Affiliations

Faculty of Medicine, University of NSW, Sydney, New South Wales, Australia. marissa.lassere@sesiahs.health.nsw.gov.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22289054

Citation

Lassere, M N., et al. "How Many Life Years Are Lost in Patients With Rheumatoid Arthritis? Secular Cause-specific and All-cause Mortality in Rheumatoid Arthritis, and Their Predictors in a Long-term Australian Cohort Study." Internal Medicine Journal, vol. 43, no. 1, 2013, pp. 66-72.
Lassere MN, Rappo J, Portek IJ, et al. How many life years are lost in patients with rheumatoid arthritis? Secular cause-specific and all-cause mortality in rheumatoid arthritis, and their predictors in a long-term Australian cohort study. Intern Med J. 2013;43(1):66-72.
Lassere, M. N., Rappo, J., Portek, I. J., Sturgess, A., & Edmonds, J. P. (2013). How many life years are lost in patients with rheumatoid arthritis? Secular cause-specific and all-cause mortality in rheumatoid arthritis, and their predictors in a long-term Australian cohort study. Internal Medicine Journal, 43(1), 66-72. https://doi.org/10.1111/j.1445-5994.2012.02727.x
Lassere MN, et al. How Many Life Years Are Lost in Patients With Rheumatoid Arthritis? Secular Cause-specific and All-cause Mortality in Rheumatoid Arthritis, and Their Predictors in a Long-term Australian Cohort Study. Intern Med J. 2013;43(1):66-72. PubMed PMID: 22289054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How many life years are lost in patients with rheumatoid arthritis? Secular cause-specific and all-cause mortality in rheumatoid arthritis, and their predictors in a long-term Australian cohort study. AU - Lassere,M N, AU - Rappo,J, AU - Portek,I J, AU - Sturgess,A, AU - Edmonds,J P, PY - 2011/06/13/received PY - 2012/01/16/accepted PY - 2012/2/1/entrez PY - 2012/2/1/pubmed PY - 2013/7/3/medline SP - 66 EP - 72 JF - Internal medicine journal JO - Intern Med J VL - 43 IS - 1 N2 - BACKGROUND: There is an excess of mortality in patients with rheumatoid arthritis (RA) but no long-term Australian cohort data. AIMS: To determine median life years lost, all-cause standardised mortality ratio (SMR) and cause-specific SMR, their predictors and secular change in Australian patients with RA. METHODS: Study population was all patients seen by a rheumatologist between 1990 and 1994. Record linkage with Australian National Death Index was performed to determine fact and cause of death up to 2004. All-cause and cause-specific SMR, and median life years lost were determined. RESULTS: There were 35 (31%) deaths in the early 1990s cohort (n = 113), SMR 1.31 (95% 0.93, 1.80). There were 216 (44%) deaths in the pre-1990s established cohort (n = 495), SMR 1.73 (1.49, 1.95). Median life years lost in the early cohort was 6 years for males and 7 years for females compared with 8 and 10 years, respectively, in the established cohort. Patients with low disease activity score at baseline (DAS < 3.2), SMR was 0.8 (0.3, 2.2) and 1.5 (1.1, 2.2) for the early and established cohorts, and if DAS ≥3.2, SMR was 1.4 (1.02, 1.98) and 1.8 (1.5, 2.1) respectively. Primary cause of death was cardiovascular disease (SMR 1.43 (1.17, 1.74). Patients at most risk were those age 45-54 years. RA was listed as a comorbid condition on the death certificate in only 16% of patients. CONCLUSIONS: Within a period of 14 years, median life expectancy of patients with RA with disease onset in the early 1990s is reduced by 6-7 years. However, our results also suggest a secular reduction in excess mortality. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/22289054/How_many_life_years_are_lost_in_patients_with_rheumatoid_arthritis_Secular_cause_specific_and_all_cause_mortality_in_rheumatoid_arthritis_and_their_predictors_in_a_long_term_Australian_cohort_study_ L2 - https://doi.org/10.1111/j.1445-5994.2012.02727.x DB - PRIME DP - Unbound Medicine ER -