Barile-Fabris Leonor A, Pérez-Cristobal Mario, Merlos-López Rosa Julia, Xibillé-Friedman Daniel
Departamento Clínico de Reumatología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2016;54 Suppl 2:S210-5.
Rheumatoid arthritis (RA) is a chronic disabling disease, which leads to joint destruction and functional limitations. It diminishes health-related quality of life (HRQoL) and life expectancy. Frailty is a chronic inflammatory process related to aging that causes disability and affects HRQoL. The presence of comorbidity and polypharmacy are both related to RA severity. The aim of this study was to assess the prevalence of frailty and comorbidities in patients with RA.
Based on the American College of Rheumatology (ACR) criteria, we studied patients with RA that were seen at the outpatient clinic of the Rheumatology Department of a third level hospital. We applied the frailty criteria according to the Cardiovascular Health Study. We registered demographic data along with comorbidities and polypharmacy, using a cross-sectional, observational, and descriptive study design.
Five hundred consecutive RA patients were included, 453 (90.6 %) were female.Mean age was 51.3 years and mean disease duration was 13.2 years; 23.4 % met frailty criteria. Mean number of comorbidities was 1.59, with systemic hypertension and obesity as the most frequent ones (25.2 % and 18.2 %, respectively). Polypharmacy was found in 99.6 % and 69.6 % received more than five drugs simultaneously.
Prevalence of frailty in this study was unexpectedly high and so were comorbidities and multiple drug usage. Clinicians should make an early detection of signs of frailty and comorbidity in RA patients.
类风湿关节炎（RA）是一种慢性致残性疾病，可导致关节破坏和功能受限。它会降低与健康相关的生活质量（HRQoL）并缩短预期寿命。衰弱是一种与衰老相关的慢性炎症过程，可导致残疾并影响HRQoL。合并症和多种药物治疗的存在均与RA的严重程度相关。本研究的目的是评估RA患者中衰弱和合并症的患病率。
根据美国风湿病学会（ACR）标准，我们研究了在一家三级医院风湿科门诊就诊的RA患者。我们根据心血管健康研究应用了衰弱标准。我们采用横断面、观察性和描述性研究设计，记录了人口统计学数据以及合并症和多种药物治疗情况。
纳入了500例连续的RA患者，其中453例（90.6%）为女性。平均年龄为51.3岁，平均病程为13.2年；23.4%符合衰弱标准。合并症的平均数量为1.59，其中系统性高血压和肥胖最为常见（分别为25.2%和18.2%）。99.6%的患者存在多种药物治疗情况，69.6%的患者同时使用超过五种药物。
本研究中衰弱的患病率出乎意料地高，合并症和多种药物使用情况也是如此。临床医生应尽早发现RA患者的衰弱和合并症迹象。
