Mortality risk associated with rheumatoid arthritis in a prospective cohort of older women: Results from the Iowa Women's Health Study

Ted R. Mikuls, K. G. Saag, L. A. Criswell, L. A. Merlino, R. A. Kaslow, B. J. Shelton, James R Cerhan

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Objective: To determine whether rheumatoid arthritis (RA) is associated with excess mortality among older women. Methods: RA associated mortality was examined in a prospective cohort study that was started in 1986, and included 31 336 women aged 55-69 years without a history of RA at baseline. Up to 1997, 158 cases of RA were identified and validated against medical records. The relative risk (RR) and 95% confidence interval (CI) were calculated as measures of association between RA onset and subsequent mortality (overall and cause-specific) using Cox proportional hazards regression. Results: Compared with non-cases, women developing RA during follow up had a significantly increased mortality risk (RR=1.52; 95% CI 1.05 to 2.20). Mortality was higher among rheumatoid factor (RF) positive cases (RR=1.90; 95% CI 1.24 to 2.92) than among RF negative cases (RR=1.00; 95% CI 0.45 to 1.99). There were trends towards increased proportions of RA related deaths from infection (RR=3.61; 95% CI 0.89-14.69) and circulatory disease (RR=1.46; 95% CI 0.76 to 2.81) but not malignancy (RR=0.97; 95% CI 0.46 to 2.04). Conclusions: RA was associated with significantly increased mortality in a cohort of older women, and the association appeared to be restricted to those with RF positive disease.

Original languageEnglish (US)
Pages (from-to)994-999
Number of pages6
JournalAnnals of the Rheumatic Diseases
Volume61
Issue number11
DOIs
StatePublished - 2002

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Women's Health
Rheumatoid Arthritis
Confidence Intervals
Mortality
Rheumatoid Factor
Medical Records
Hazards
Cohort Studies
Prospective Studies
Infection

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

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Mortality risk associated with rheumatoid arthritis in a prospective cohort of older women : Results from the Iowa Women's Health Study. / Mikuls, Ted R.; Saag, K. G.; Criswell, L. A.; Merlino, L. A.; Kaslow, R. A.; Shelton, B. J.; Cerhan, James R.

In: Annals of the Rheumatic Diseases, Vol. 61, No. 11, 2002, p. 994-999.

Research output: Contribution to journalArticle

Mikuls, Ted R. ; Saag, K. G. ; Criswell, L. A. ; Merlino, L. A. ; Kaslow, R. A. ; Shelton, B. J. ; Cerhan, James R. / Mortality risk associated with rheumatoid arthritis in a prospective cohort of older women : Results from the Iowa Women's Health Study. In: Annals of the Rheumatic Diseases. 2002 ; Vol. 61, No. 11. pp. 994-999.
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abstract = "Objective: To determine whether rheumatoid arthritis (RA) is associated with excess mortality among older women. Methods: RA associated mortality was examined in a prospective cohort study that was started in 1986, and included 31 336 women aged 55-69 years without a history of RA at baseline. Up to 1997, 158 cases of RA were identified and validated against medical records. The relative risk (RR) and 95{\%} confidence interval (CI) were calculated as measures of association between RA onset and subsequent mortality (overall and cause-specific) using Cox proportional hazards regression. Results: Compared with non-cases, women developing RA during follow up had a significantly increased mortality risk (RR=1.52; 95{\%} CI 1.05 to 2.20). Mortality was higher among rheumatoid factor (RF) positive cases (RR=1.90; 95{\%} CI 1.24 to 2.92) than among RF negative cases (RR=1.00; 95{\%} CI 0.45 to 1.99). There were trends towards increased proportions of RA related deaths from infection (RR=3.61; 95{\%} CI 0.89-14.69) and circulatory disease (RR=1.46; 95{\%} CI 0.76 to 2.81) but not malignancy (RR=0.97; 95{\%} CI 0.46 to 2.04). Conclusions: RA was associated with significantly increased mortality in a cohort of older women, and the association appeared to be restricted to those with RF positive disease.",
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N2 - Objective: To determine whether rheumatoid arthritis (RA) is associated with excess mortality among older women. Methods: RA associated mortality was examined in a prospective cohort study that was started in 1986, and included 31 336 women aged 55-69 years without a history of RA at baseline. Up to 1997, 158 cases of RA were identified and validated against medical records. The relative risk (RR) and 95% confidence interval (CI) were calculated as measures of association between RA onset and subsequent mortality (overall and cause-specific) using Cox proportional hazards regression. Results: Compared with non-cases, women developing RA during follow up had a significantly increased mortality risk (RR=1.52; 95% CI 1.05 to 2.20). Mortality was higher among rheumatoid factor (RF) positive cases (RR=1.90; 95% CI 1.24 to 2.92) than among RF negative cases (RR=1.00; 95% CI 0.45 to 1.99). There were trends towards increased proportions of RA related deaths from infection (RR=3.61; 95% CI 0.89-14.69) and circulatory disease (RR=1.46; 95% CI 0.76 to 2.81) but not malignancy (RR=0.97; 95% CI 0.46 to 2.04). Conclusions: RA was associated with significantly increased mortality in a cohort of older women, and the association appeared to be restricted to those with RF positive disease.

AB - Objective: To determine whether rheumatoid arthritis (RA) is associated with excess mortality among older women. Methods: RA associated mortality was examined in a prospective cohort study that was started in 1986, and included 31 336 women aged 55-69 years without a history of RA at baseline. Up to 1997, 158 cases of RA were identified and validated against medical records. The relative risk (RR) and 95% confidence interval (CI) were calculated as measures of association between RA onset and subsequent mortality (overall and cause-specific) using Cox proportional hazards regression. Results: Compared with non-cases, women developing RA during follow up had a significantly increased mortality risk (RR=1.52; 95% CI 1.05 to 2.20). Mortality was higher among rheumatoid factor (RF) positive cases (RR=1.90; 95% CI 1.24 to 2.92) than among RF negative cases (RR=1.00; 95% CI 0.45 to 1.99). There were trends towards increased proportions of RA related deaths from infection (RR=3.61; 95% CI 0.89-14.69) and circulatory disease (RR=1.46; 95% CI 0.76 to 2.81) but not malignancy (RR=0.97; 95% CI 0.46 to 2.04). Conclusions: RA was associated with significantly increased mortality in a cohort of older women, and the association appeared to be restricted to those with RF positive disease.

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