Rheumatology, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Ann Rheum Dis. 2016 Aug;75(8):1466-72. doi: 10.1136/annrheumdis-2015-207688. Epub 2015 Sep 2.
Information on mortality in ankylosing spondylitis (AS) is scarce. Our study therefore aimed to assess: (1) mortality in AS versus the general population, and (2) predictors of death in the AS population.
Nationwide cohorts of patients with AS diagnosed at rheumatology or internal medicine outpatient clinics (n=8600) and age-matched, sex-matched and county-matched general population comparators (n=40 460) were identified from the National Patient Register and the census register, respectively. The follow-up period began on 1 January 2006 or at the first date of registered diagnosis thereafter and extended until death, emigration or 31 December 2012, whichever occurred first. Socioeconomic variables, AS-related clinical manifestations, joint surgery, comorbidities and medication were identified from other national registers. Cox regression models were used to determine mortality and predictors for death in the AS cohort.
There were 496 deaths in the AS cohort and 1533 deaths in the control cohort resulting in an age-adjusted and sex-adjusted HR of 1.60 (95% CI 1.44 to 1.77), with increased mortality for men (age-adjusted HR=1.53, 95% CI 1.36 to 1.72) and women (age-adjusted HR=1.83, 95% CI 1.50 to 2.22). Within the AS cohort, statistically significant predictors for death were a lower level of education, general comorbidities (diabetes, infections, cardiovascular, pulmonary and malignant diseases) and previous hip replacement surgery.
Mortality was increased for male and female patients with AS. Predictors of death within the AS cohort included socioeconomic status, general comorbidities and hip replacement surgery.
强直性脊柱炎（AS）患者的死亡率信息较为匮乏。因此，本研究旨在评估：（1）AS 患者与普通人群相比的死亡率，以及（2）AS 患者死亡的预测因素。
从全国患者登记处和人口普查登记处分别确定了在风湿病或内科门诊诊断为 AS 的患者的全国性队列（n=8600）和年龄、性别和县级匹配的普通人群对照者（n=40460）。随访期从 2006 年 1 月 1 日或之后首次登记诊断之日开始，持续到死亡、移民或 2012 年 12 月 31 日，以先发生者为准。社会经济变量、AS 相关临床表现、关节手术、合并症和药物使用情况均从其他国家登记处确定。使用 Cox 回归模型确定 AS 队列的死亡率和死亡预测因素。
AS 队列中有 496 例死亡，对照组中有 1533 例死亡，导致年龄和性别调整后的 HR 为 1.60（95%CI 1.44-1.77），男性（年龄调整后的 HR=1.53，95%CI 1.36-1.72）和女性（年龄调整后的 HR=1.83，95%CI 1.50-2.22）的死亡率均升高。在 AS 队列中，死亡的统计学显著预测因素包括教育程度较低、一般合并症（糖尿病、感染、心血管、肺部和恶性疾病）以及先前的髋关节置换手术。
男性和女性 AS 患者的死亡率均升高。AS 队列中死亡的预测因素包括社会经济地位、一般合并症和髋关节置换手术。
