Causes of death and prognostic indicators of rheumatoid arthritis / 中华风湿病学杂志

ABSTRACT

Objective To analyze the causes of death and prognostic indicators of rheumatoid arthritis (RA).Methods A retrospective investigation was performed on 91 RA patients who were admitted into our hospital from 1990 to 2011.The clinical features and laboratory data were studied to assess the causes of death and the relationship between causes of death and disease activity and treatment.T test and x2 test were used for statistical analysis.Prognostic indicators of mortality were studied by Cox propor-tional hazards models.The prognostic indicators of RA were also analyzed.Results The three most common causes of death in patients with RA were infection (57％),cardiac-cerebral vascular diseases (13％) and cancer (12％).Severe disease activity and presence of extra-articular manifestations were more common among the patients who died.Seventy-five percent patients presented with systemic symptoms including fever,fatigue and weight loss,followed by pulmonary fibrosis (32％) and pleural effusion (27％).Cox regression analysis revealed that the presence of extra-articular features was independent risk determinant for mortality while DMARDs treatment was the independent protect determinant.Conclusion Infection,cardiac-cerebral vascular diseases and cancer are the main causes of death in RA.The presence of extra-articular features is the independent risk factor of RA.