Survival study of rheumatoid arthritis patients in Madrid (Spain) -: A 9-year prospective follow-up

Objective: To determine the risk and causes of death in rheumatoid arthritis (RA) patients in Madrid. Methods: A longitudinal survival analysis was made. 182 RA patients of the rheumatology clinic of a tertiary care hospital were studied, 42 (23%) males and 140 (77%) females. All were followed-up for a 9-year period or to the date of death. Kaplan-Meier survival curves for both male and female cohorts were performed. The logrank test was used to compare both distributions and to determine the statistical significance. Results: The mortality rate for the RA patient cohort was 15.4 deaths/1000 person-years (10.2/1000 for the female and 34.2/1000 for the male cohorts). The mortality rate ratio was 3.3. The logrank test showed a statistical difference (p=0.0023). The standardized mortality ratio was 1.85 for RA patients. The causes of death were: cardiovascular diseases 5 (21%), infections 5 (21%), amyloidosis 4 (17%), malignant diseases 2 (8%). Conclusions: Mortality is nearly two times higher in our population of RA patients. Male patients have a much lower survival probability than females. Cardiovascular diseases, infections and amyloidosis were the most common causes of death.