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Rheumatoid arthritis is associated with an increased mortality compared with the general population.1 Disability2 and severe extra-articular rheumatoid arthritis (ExRA) manifestations3 predict mortality in patients with rheumatoid arthritis. In a previous study of a community-based sample of patients with rheumatoid arthritis, we showed that ExRA was a strong predictor of mortality, whereas the survival of patients with rheumatoid arthritis without severe ExRA was not largely different from the background population.4 We have now studied the effect of multiple ExRA manifestations on mortality.
Using the resources of the Rochester Epidemiology Project, all patients with rheumatoid arthritis residing in Rochester, Minnesota, with a disease onset between 1 January 1955 and 31 December 1994 were …
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