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a Department
of Rheumatology, University Medical Centre Nijmegen, Nijmegen, The
Netherlands, b Department of Rheumatology, University Hospital
Groningen, Groningen, The Netherlands
Correspondence to: Dr E J A Kroot, Department of Rheumatology, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands E.Kroot{at}reuma.azn.nl
Accepted for publication 18 August
2000
OBJECTIVE
To
investigate mortality, functional capacity, and prognostic factors for
mortality in an inception cohort of patients with recently diagnosed RA
followed up for up to 10 years.
METHODSThe observed
mortality of this inception cohort with recently diagnosed RA, was
analysed in relation to the expected mortality, calculated with the aid
of life tables of the general population of the Netherlands (matched
for age and sex). Functional capacity was measured by the Health
Assessment Questionnaire. Prognostic factors for mortality were
analysed multivariately by the Cox proportional hazards model.
RESULTSBetween
January 1985 and April 1997, 622 patients entered the study, and were
included in the analysis of mortality. The death rate in the first 10 years of the disease was not significantly different from that of the
general population. Fifty five patients from the study group died (16%
up to 10 years of follow up). The most commonly reported causes of
death were of cardiovascular and respiratory origin. The other causes
of death could be classified into cancer, sepsis, amyloidosis,
leukaemia, renal insufficiency of unknown cause, perforation of the
oesophagus, probably related to the treatment with non-steroidal
anti-inflammatory drugs, and pancytopenia during aurothioglucose
treatment. Functional capacity improved significantly during the first
six years compared with the value at start. Statistically significant
predictors for death were age at the start and male sex.
CONCLUSIONSIn
contrast with earlier studies performed, no excess mortality in the
first 10 years of an inception cohort of patients with RA was seen. In
addition, the functional capacity was relatively constant during the
first six years after an initial improvement from baseline. Age at
start and male sex were the only statistically significant predictors
for death.
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