Intriago Maria, Maldonado Genessis, Guerrero Roberto, Moreno Mario, Moreno Letty, Rios Carlos
Rheumatology Department, Universidad Espiritu Santo, Guayaquil, Ecuador.
Open Access Rheumatol. 2020 Jun 10;12:97-104. doi: 10.2147/OARRR.S251725. eCollection 2020.
Disability in RA is associated with loss of workdays, greater use of health resources and a higher prevalence of depression. The purpose of this study was to determine the prevalence of functional disability and the factors associated with it.
A cross-sectional study was carried out during January-June 2019 at a rheumatology clinic in the city of Guayaquil. Patients with pre-established RA were included. Functional disability was measured using the HAQ-DI. Data were analyzed using the statistical program SPSS v22. We compared characteristics between patients with and without disability using Student's -test and chi-square. A multiple logistic regression model for functional disability was made.
We included 395 patients, 87.8% female and 12.2% male with a mean age of 51.4±12 years and mean duration of disease 13.8±7 years. Most patients had extra-articular manifestations (80.8%) and comorbidities (81.3%). The mean HAQ-DI was 0.8±0.9, with a prevalence of disability of 26.6%. We found a statistically significant relationship between disability and female sex (p=0.018), age (p=0.020), presence of extra-articular manifestations (p=0.008), myalgia (p<0.001) and fatigue (p<0.001). In addition, patients with disabilities had a lower employment rate (26.7%) compared to those without disability (45.5%, p=0.001). In the multivariate logistic analysis, only depression (p=0.029), diabetes (p=0.003), SJC (p=0.001) and VAS of pain (p=0.004) were significantly related to functional disability.
Disability affects a quarter of patients with RA. Among the determinants of disability, we found female sex, older age, grade of pain, inflammatory markers and the level of disease activity.
类风湿关节炎（RA）患者的残疾与工作日损失、更多地使用医疗资源以及更高的抑郁症患病率相关。本研究的目的是确定功能残疾的患病率及其相关因素。
2019年1月至6月在瓜亚基尔市的一家风湿病诊所进行了一项横断面研究。纳入已确诊为RA的患者。使用健康评估问卷残疾指数（HAQ-DI）来测量功能残疾。数据使用统计软件SPSS v22进行分析。我们使用学生t检验和卡方检验比较了有残疾和无残疾患者之间的特征。建立了功能残疾的多元逻辑回归模型。
我们纳入了395例患者，其中女性占87.8%，男性占12.2%，平均年龄为51.4±12岁，平均病程为13.8±7年。大多数患者有关节外表现（80.8%）和合并症（81.3%）。HAQ-DI的平均值为0.8±0.9，残疾患病率为26.6%。我们发现残疾与女性性别（p=0.018）、年龄（p=0.020）、关节外表现的存在（p=0.008）、肌痛（p<0.001）和疲劳（p<0.001）之间存在统计学上的显著关系。此外，与无残疾患者相比，残疾患者的就业率较低（26.7%对45.5%，p=0.001）。在多因素逻辑分析中，只有抑郁症（p=0.029）、糖尿病（p=0.003）、肿胀关节计数（SJC）（p=0.001）和疼痛视觉模拟评分（VAS）（p=0.004）与功能残疾显著相关。
残疾影响四分之一的RA患者。在残疾的决定因素中，我们发现了女性性别、年龄较大、疼痛程度、炎症标志物和疾病活动水平。
