The mortality of rheumatoid arthritis
Article first published online: 9 DEC 2005
Copyright © 1994 American College of Rheumatology
Arthritis & Rheumatism
Volume 37, Issue 4, pages 481–494, December 1994
How to Cite
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. and Cathey, M. A. (1994), The mortality of rheumatoid arthritis. Arthritis & Rheumatism, 37: 481–494. doi: 10.1002/art.1780370408
- Issue published online: 9 DEC 2005
- Article first published online: 9 DEC 2005
- Manuscript Accepted: 19 AUG 1993
- Manuscript Received: 21 APR 1993
- Kansas Chapter, Arthritis Foundation, Wichita, Kansas, National Institutes of Arthritis, Diabetes, Digestive, and Kidney Diseases. Grant Number: AM-21393
- Arthritis, Rheumatism, and Aging Medical Information System
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.