National Study of Cause-Specific Mortality in Rheumatoid Arthritis, Juvenile Chronic Arthritis, and other Rheumatic Conditions: a 20 year follow-up study

E. Thomas, D. P. M. Symmons, D. H. Brewster, R. J. Black, Gary John MacFarlane

Research output: Contribution to journalEditorial

118 Citations (Scopus)

Abstract

Objective. To quantify risks for cause-specific mortality among hospitalized patients with rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), and 4 other rheumatic conditions in a nationwide, population based cohort over a 20 year period.

Methods. All subjects were identified from Scottish hospital inpatient records from 1981 to 2000 and were followed up by computer linkage to the national registry of deaths. Expected mortality was calculated from national mortality rates and was related to the observed incidence by the standardized mortality ratio (SMR) and the corresponding 95% confidence interval (95% CI).

Results. Overall mortality was elevated in each of the 6 rheumatic conditions examined, most notably in JCA (males: SMR 3.4, 95% CI 2.0,5. 5; females: SMR 5.1, 95% CI 3.2,7.8). Among patients with RA, there was an increased risk for death in all International Classification of Disease chapters other than those relating to mental disorders. Specific causes of death with an increased risk for subjects with RA included lung cancer [males: 1.4 (1.2,1.5); females: 1.6 (1.5,1.8)], hematopoietic malignancies [M: 1.8 (1.4,2.3); F: 2.0 (1.7,2.3)], coronary artery disease (CAD) [M: 1.6 (1.5,1.7); F: 1.95 (1.9,2.0)], respiratory infections [M: 1.9 (1.7,2.2); F: 2.4 (2.3,2.6)], chronic obstructive pulmonary disease [M: 1.8 (1.6,2.0); F: 2.1 (1.9,2.3)], and renal failure [M: 3.1 (2.5,3.9); F: 3.5 (3.0,4.0)]. Conversely, RA subjects were less likely to die from gastrointestinal tract malignancies [M: 0.82 (0.7,1.0); F: 0.8 (0.7,0.9)].

Conclusion. Population studies for primary data collection are required to extend our knowledge about the underlying mechanisms of early mortality in patients with rheumatic conditions.

Original languageEnglish
Pages (from-to)958-965
Number of pages7
JournalJournal of Rheumatology
Volume30
Issue number5
Publication statusPublished - 2003

Keywords

  • mortality
  • rheumatoid arthritis
  • juvenile chronic arthritis
  • hospital cohort
  • CARDIOVASCULAR MORTALITY
  • SYSTEMIC-SCLEROSIS
  • SJOGRENS-SYNDROME
  • RISK-FACTORS
  • DEATH
  • POPULATION
  • COHORT
  • SCLERODERMA
  • MORBIDITY
  • SURVIVAL

Cite this

National Study of Cause-Specific Mortality in Rheumatoid Arthritis, Juvenile Chronic Arthritis, and other Rheumatic Conditions: a 20 year follow-up study. / Thomas, E.; Symmons, D. P. M.; Brewster, D. H.; Black, R. J.; MacFarlane, Gary John.

In: Journal of Rheumatology, Vol. 30, No. 5, 2003, p. 958-965.

Research output: Contribution to journalEditorial

@article{5e5ab536d3094bbaaf7957d4d2a1f27c,
title = "National Study of Cause-Specific Mortality in Rheumatoid Arthritis, Juvenile Chronic Arthritis, and other Rheumatic Conditions: a 20 year follow-up study",
abstract = "Objective. To quantify risks for cause-specific mortality among hospitalized patients with rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), and 4 other rheumatic conditions in a nationwide, population based cohort over a 20 year period.Methods. All subjects were identified from Scottish hospital inpatient records from 1981 to 2000 and were followed up by computer linkage to the national registry of deaths. Expected mortality was calculated from national mortality rates and was related to the observed incidence by the standardized mortality ratio (SMR) and the corresponding 95{\%} confidence interval (95{\%} CI).Results. Overall mortality was elevated in each of the 6 rheumatic conditions examined, most notably in JCA (males: SMR 3.4, 95{\%} CI 2.0,5. 5; females: SMR 5.1, 95{\%} CI 3.2,7.8). Among patients with RA, there was an increased risk for death in all International Classification of Disease chapters other than those relating to mental disorders. Specific causes of death with an increased risk for subjects with RA included lung cancer [males: 1.4 (1.2,1.5); females: 1.6 (1.5,1.8)], hematopoietic malignancies [M: 1.8 (1.4,2.3); F: 2.0 (1.7,2.3)], coronary artery disease (CAD) [M: 1.6 (1.5,1.7); F: 1.95 (1.9,2.0)], respiratory infections [M: 1.9 (1.7,2.2); F: 2.4 (2.3,2.6)], chronic obstructive pulmonary disease [M: 1.8 (1.6,2.0); F: 2.1 (1.9,2.3)], and renal failure [M: 3.1 (2.5,3.9); F: 3.5 (3.0,4.0)]. Conversely, RA subjects were less likely to die from gastrointestinal tract malignancies [M: 0.82 (0.7,1.0); F: 0.8 (0.7,0.9)].Conclusion. Population studies for primary data collection are required to extend our knowledge about the underlying mechanisms of early mortality in patients with rheumatic conditions.",
keywords = "mortality, rheumatoid arthritis, juvenile chronic arthritis, hospital cohort, CARDIOVASCULAR MORTALITY, SYSTEMIC-SCLEROSIS, SJOGRENS-SYNDROME, RISK-FACTORS, DEATH, POPULATION, COHORT, SCLERODERMA, MORBIDITY, SURVIVAL",
author = "E. Thomas and Symmons, {D. P. M.} and Brewster, {D. H.} and Black, {R. J.} and MacFarlane, {Gary John}",
year = "2003",
language = "English",
volume = "30",
pages = "958--965",
journal = "Journal of Rheumatology",
issn = "0315-162X",
publisher = "Journal of Rheumatology",
number = "5",

}

TY - JOUR

T1 - National Study of Cause-Specific Mortality in Rheumatoid Arthritis, Juvenile Chronic Arthritis, and other Rheumatic Conditions: a 20 year follow-up study

AU - Thomas, E.

AU - Symmons, D. P. M.

AU - Brewster, D. H.

AU - Black, R. J.

AU - MacFarlane, Gary John

PY - 2003

Y1 - 2003

N2 - Objective. To quantify risks for cause-specific mortality among hospitalized patients with rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), and 4 other rheumatic conditions in a nationwide, population based cohort over a 20 year period.Methods. All subjects were identified from Scottish hospital inpatient records from 1981 to 2000 and were followed up by computer linkage to the national registry of deaths. Expected mortality was calculated from national mortality rates and was related to the observed incidence by the standardized mortality ratio (SMR) and the corresponding 95% confidence interval (95% CI).Results. Overall mortality was elevated in each of the 6 rheumatic conditions examined, most notably in JCA (males: SMR 3.4, 95% CI 2.0,5. 5; females: SMR 5.1, 95% CI 3.2,7.8). Among patients with RA, there was an increased risk for death in all International Classification of Disease chapters other than those relating to mental disorders. Specific causes of death with an increased risk for subjects with RA included lung cancer [males: 1.4 (1.2,1.5); females: 1.6 (1.5,1.8)], hematopoietic malignancies [M: 1.8 (1.4,2.3); F: 2.0 (1.7,2.3)], coronary artery disease (CAD) [M: 1.6 (1.5,1.7); F: 1.95 (1.9,2.0)], respiratory infections [M: 1.9 (1.7,2.2); F: 2.4 (2.3,2.6)], chronic obstructive pulmonary disease [M: 1.8 (1.6,2.0); F: 2.1 (1.9,2.3)], and renal failure [M: 3.1 (2.5,3.9); F: 3.5 (3.0,4.0)]. Conversely, RA subjects were less likely to die from gastrointestinal tract malignancies [M: 0.82 (0.7,1.0); F: 0.8 (0.7,0.9)].Conclusion. Population studies for primary data collection are required to extend our knowledge about the underlying mechanisms of early mortality in patients with rheumatic conditions.

AB - Objective. To quantify risks for cause-specific mortality among hospitalized patients with rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), and 4 other rheumatic conditions in a nationwide, population based cohort over a 20 year period.Methods. All subjects were identified from Scottish hospital inpatient records from 1981 to 2000 and were followed up by computer linkage to the national registry of deaths. Expected mortality was calculated from national mortality rates and was related to the observed incidence by the standardized mortality ratio (SMR) and the corresponding 95% confidence interval (95% CI).Results. Overall mortality was elevated in each of the 6 rheumatic conditions examined, most notably in JCA (males: SMR 3.4, 95% CI 2.0,5. 5; females: SMR 5.1, 95% CI 3.2,7.8). Among patients with RA, there was an increased risk for death in all International Classification of Disease chapters other than those relating to mental disorders. Specific causes of death with an increased risk for subjects with RA included lung cancer [males: 1.4 (1.2,1.5); females: 1.6 (1.5,1.8)], hematopoietic malignancies [M: 1.8 (1.4,2.3); F: 2.0 (1.7,2.3)], coronary artery disease (CAD) [M: 1.6 (1.5,1.7); F: 1.95 (1.9,2.0)], respiratory infections [M: 1.9 (1.7,2.2); F: 2.4 (2.3,2.6)], chronic obstructive pulmonary disease [M: 1.8 (1.6,2.0); F: 2.1 (1.9,2.3)], and renal failure [M: 3.1 (2.5,3.9); F: 3.5 (3.0,4.0)]. Conversely, RA subjects were less likely to die from gastrointestinal tract malignancies [M: 0.82 (0.7,1.0); F: 0.8 (0.7,0.9)].Conclusion. Population studies for primary data collection are required to extend our knowledge about the underlying mechanisms of early mortality in patients with rheumatic conditions.

KW - mortality

KW - rheumatoid arthritis

KW - juvenile chronic arthritis

KW - hospital cohort

KW - CARDIOVASCULAR MORTALITY

KW - SYSTEMIC-SCLEROSIS

KW - SJOGRENS-SYNDROME

KW - RISK-FACTORS

KW - DEATH

KW - POPULATION

KW - COHORT

KW - SCLERODERMA

KW - MORBIDITY

KW - SURVIVAL

M3 - Editorial

VL - 30

SP - 958

EP - 965

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 5

ER -