Mortality and its predictors in patients with rheumatoid arthritis: a Danish population-based inception cohort study

J. Pedersen*, R. Holst, J. Primdahl, A. Svendsen, K. Hørslev-Petersen

*Corresponding author for this work

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Abstract

Objectives: To investigate mortality and its predictors in a retrospectively defined population-based rheumatoid arthritis (RA) inception cohort Method: We included patients ascertained with incident RA from a region in the southern part of Denmark from 1995 to 2002. All patients fulfilled the 1987 American College of Rheumatology criteria for RA. The patients were followed from RA classification until death, emigration, or end of follow-up on 31 December 2013. We used personal record linkage with national public registers to obtain information on education, employment, cohabitation, comorbidity, and vital status. Results: The cohort comprised 509 patients, of whom 200 (39%) died during 6079 person-years. The most frequent underlying causes of death were cardiovascular disease (34%), neoplasms (26%), and respiratory disease (12%). In rheumatoid factor (RF)-positive males, the standardized mortality ratio (95% confidence interval) from all causes was 1.47 (1.15–1.88), from cardiovascular disease 1.63 (1.09–2.46), from respiratory disease 2.03 (1.06–3.90), and from neoplasms 2.26 (1.02–5.03) in the age group < 70 years, and 2.45 (1.23–4.90) in the age group > 79 years. On applying Cox models after multiple imputations by chained equations, we found that RF modified the effect of age. Employment status, comorbidity, and gender were independent baseline predictors of subsequent mortality. Conclusion: In this cohort, significant excess mortality was confined to RF-positive males. The effect of age was modified by RF, and employment status and comorbidity were independent predictors of mortality.

Original languageEnglish
JournalScandinavian Journal of Rheumatology
Volume47
Issue number5
Pages (from-to)371-377
ISSN0300-9742
DOIs
Publication statusPublished - Sep 2018

Fingerprint

Rheumatoid Factor
Cohort Studies
Comorbidity
Population
Emigration and Immigration
Denmark
Proportional Hazards Models
Cause of Death
Neoplasms
Age Groups
Confidence Intervals
Education

Keywords

  • Adolescent
  • Adult
  • Aged
  • Arthritis, Rheumatoid/mortality
  • Cause of Death
  • Cohort Studies
  • Denmark
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Cite this

@article{bf1e98b8dbda4ef39f94d0c020a8ef26,
title = "Mortality and its predictors in patients with rheumatoid arthritis: a Danish population-based inception cohort study",
abstract = "Objectives: To investigate mortality and its predictors in a retrospectively defined population-based rheumatoid arthritis (RA) inception cohort Method: We included patients ascertained with incident RA from a region in the southern part of Denmark from 1995 to 2002. All patients fulfilled the 1987 American College of Rheumatology criteria for RA. The patients were followed from RA classification until death, emigration, or end of follow-up on 31 December 2013. We used personal record linkage with national public registers to obtain information on education, employment, cohabitation, comorbidity, and vital status. Results: The cohort comprised 509 patients, of whom 200 (39{\%}) died during 6079 person-years. The most frequent underlying causes of death were cardiovascular disease (34{\%}), neoplasms (26{\%}), and respiratory disease (12{\%}). In rheumatoid factor (RF)-positive males, the standardized mortality ratio (95{\%} confidence interval) from all causes was 1.47 (1.15–1.88), from cardiovascular disease 1.63 (1.09–2.46), from respiratory disease 2.03 (1.06–3.90), and from neoplasms 2.26 (1.02–5.03) in the age group < 70 years, and 2.45 (1.23–4.90) in the age group > 79 years. On applying Cox models after multiple imputations by chained equations, we found that RF modified the effect of age. Employment status, comorbidity, and gender were independent baseline predictors of subsequent mortality. Conclusion: In this cohort, significant excess mortality was confined to RF-positive males. The effect of age was modified by RF, and employment status and comorbidity were independent predictors of mortality.",
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author = "J. Pedersen and R. Holst and J. Primdahl and A. Svendsen and K. H{\o}rslev-Petersen",
year = "2018",
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language = "English",
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}

Mortality and its predictors in patients with rheumatoid arthritis : a Danish population-based inception cohort study. / Pedersen, J.; Holst, R.; Primdahl, J.; Svendsen, A.; Hørslev-Petersen, K.

In: Scandinavian Journal of Rheumatology, Vol. 47, No. 5, 09.2018, p. 371-377.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Mortality and its predictors in patients with rheumatoid arthritis

T2 - a Danish population-based inception cohort study

AU - Pedersen, J.

AU - Holst, R.

AU - Primdahl, J.

AU - Svendsen, A.

AU - Hørslev-Petersen, K.

PY - 2018/9

Y1 - 2018/9

N2 - Objectives: To investigate mortality and its predictors in a retrospectively defined population-based rheumatoid arthritis (RA) inception cohort Method: We included patients ascertained with incident RA from a region in the southern part of Denmark from 1995 to 2002. All patients fulfilled the 1987 American College of Rheumatology criteria for RA. The patients were followed from RA classification until death, emigration, or end of follow-up on 31 December 2013. We used personal record linkage with national public registers to obtain information on education, employment, cohabitation, comorbidity, and vital status. Results: The cohort comprised 509 patients, of whom 200 (39%) died during 6079 person-years. The most frequent underlying causes of death were cardiovascular disease (34%), neoplasms (26%), and respiratory disease (12%). In rheumatoid factor (RF)-positive males, the standardized mortality ratio (95% confidence interval) from all causes was 1.47 (1.15–1.88), from cardiovascular disease 1.63 (1.09–2.46), from respiratory disease 2.03 (1.06–3.90), and from neoplasms 2.26 (1.02–5.03) in the age group < 70 years, and 2.45 (1.23–4.90) in the age group > 79 years. On applying Cox models after multiple imputations by chained equations, we found that RF modified the effect of age. Employment status, comorbidity, and gender were independent baseline predictors of subsequent mortality. Conclusion: In this cohort, significant excess mortality was confined to RF-positive males. The effect of age was modified by RF, and employment status and comorbidity were independent predictors of mortality.

AB - Objectives: To investigate mortality and its predictors in a retrospectively defined population-based rheumatoid arthritis (RA) inception cohort Method: We included patients ascertained with incident RA from a region in the southern part of Denmark from 1995 to 2002. All patients fulfilled the 1987 American College of Rheumatology criteria for RA. The patients were followed from RA classification until death, emigration, or end of follow-up on 31 December 2013. We used personal record linkage with national public registers to obtain information on education, employment, cohabitation, comorbidity, and vital status. Results: The cohort comprised 509 patients, of whom 200 (39%) died during 6079 person-years. The most frequent underlying causes of death were cardiovascular disease (34%), neoplasms (26%), and respiratory disease (12%). In rheumatoid factor (RF)-positive males, the standardized mortality ratio (95% confidence interval) from all causes was 1.47 (1.15–1.88), from cardiovascular disease 1.63 (1.09–2.46), from respiratory disease 2.03 (1.06–3.90), and from neoplasms 2.26 (1.02–5.03) in the age group < 70 years, and 2.45 (1.23–4.90) in the age group > 79 years. On applying Cox models after multiple imputations by chained equations, we found that RF modified the effect of age. Employment status, comorbidity, and gender were independent baseline predictors of subsequent mortality. Conclusion: In this cohort, significant excess mortality was confined to RF-positive males. The effect of age was modified by RF, and employment status and comorbidity were independent predictors of mortality.

KW - Adolescent

KW - Adult

KW - Aged

KW - Arthritis, Rheumatoid/mortality

KW - Cause of Death

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Proportional Hazards Models

KW - Registries

KW - Retrospective Studies

KW - Risk Factors

KW - Young Adult

U2 - 10.1080/03009742.2017.1420223

DO - 10.1080/03009742.2017.1420223

M3 - Journal article

C2 - 29741136

AN - SCOPUS:85046697602

VL - 47

SP - 371

EP - 377

JO - Scandinavian Journal of Rheumatology

JF - Scandinavian Journal of Rheumatology

SN - 0300-9742

IS - 5

ER -