基于人群的女性类风湿关节炎死亡率结果

New York Life Insurance Company, 51 Madison Avenue, New, York, NY 10010, USA.

J Insur Med. 2002;34(2):86-8.

UNLABELLED

Rheumatoid arthritis (RA) is a systemic disease whose morbidity exceeds its mortality. This abstract quantifies the mortality of RA in a general population over a 30-year period in females. The generic, across the spectrum of disease, mortality ratio is 136%; the excess death rate is 12. The mortality impact on males is minimal; the source publication noted a mortality ratio of 107%. Many selected cases of RA can be underwritten very favorably.

PURPOSE

To quantify the excess mortality in females diagnosed with rheumatoid arthritis (RA) between 1955 to 1985.

SUBJECTS AND METHODS

Medical records of all residents age 35 and over of Rochester, Minnesota, who met the American College of Rheumatology 1987 diagnostic criteria for RA were reviewed. Based on the comprehensive statistical base for residents in Rochester, virtually complete ascertainment of all clinically recognized cases of RA were identified. An incidence cohort identifying the same residents with new cases of RA occurring between January 1, 1955, and January 1, 1985, was created. Three, 10-year prevalence cohorts were assembled as of July 1, 1965, 1975 and 1985. Patients in each cohort were followed longitudinally until death or migration from Rochester. Data of disease characteristics, course, co-morbidity and death were collected. During the follow-up period, 6.9% moved out of the county, and 5.1% moved into the county after the diagnosis of RA had been made elsewhere. Expected survival was based on age and sex adjusted survival from the same community in the same time period. Mortality was described using the Kaplan-Meier product-limit method. Cox proportional hazards modeling was used to examine the effects of age, sex and rheumatoid factor on survival.

DATA

In the 1965, 1975 and 1985 prevalence cohorts, there were 163, 235 and 272 cases of RA, respectively. Some individuals were present in more than one. Deaths in each cohort were 54, 93 and 111, respectively. Median follow-up was 12.7 years for the entire group with the earlier groups being longer. Mean follow-up was 15.1 years. Seventy-three percent of patients were females. The average age at diagnosis was 60.2 years.

未标注

类风湿关节炎（RA）是一种发病率高于死亡率的全身性疾病。本摘要对女性普通人群中30年内类风湿关节炎的死亡率进行了量化。在整个疾病谱中，一般死亡率比为136%；超额死亡率为12。对男性的死亡影响极小；原始出版物指出死亡率比为107%。许多选定的类风湿关节炎病例可以得到非常优惠的承保。

目的

量化1955年至1985年间被诊断为类风湿关节炎（RA）的女性的超额死亡率。

对象与方法

回顾了明尼苏达州罗切斯特市所有35岁及以上居民的病历，这些居民符合美国风湿病学会1987年类风湿关节炎诊断标准。基于罗切斯特市居民全面的统计数据库，几乎确定了所有临床确诊的类风湿关节炎病例。创建了一个发病队列，确定了1955年1月1日至1985年1月1日期间出现类风湿关节炎新病例的相同居民。截至1965年7月1日、1975年和1985年，组建了三个10年患病率队列。对每个队列中的患者进行纵向随访，直至死亡或从罗切斯特市迁出。收集疾病特征、病程、合并症和死亡数据。在随访期间，6.9%的患者在其他地方被诊断为类风湿关节炎后迁出该县，5.1%的患者迁入该县。预期生存基于同一时期同一社区按年龄和性别调整的生存情况。使用Kaplan-Meier乘积限法描述死亡率。使用Cox比例风险模型来检验年龄、性别和类风湿因子对生存的影响。

数据

在1965年、1975年和1985年的患病率队列中，分别有163例、235例和272例类风湿关节炎病例。有些个体出现在不止一个队列中。每个队列中的死亡人数分别为54例、93例和111例。整个组的中位随访时间为12.7年，早期队列的随访时间更长。平均随访时间为15.1年。73%的患者为女性。诊断时的平均年龄为60.2岁。