RT Journal Article
SR Electronic
T1 Does social disadvantage contribute to the excess mortality in rheumatoid arthritis patients?
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 525
OP 529
DO 10.1136/ard.58.9.525
VO 58
IS 9
A1 Maiden, N
A1 Capell, H A
A1 Madhok, R
A1 Hampson, R
A1 Thomson, E A
YR 1999
UL http://ard.bmj.com/content/58/9/525.abstract
AB BACKGROUND Socioeconomic deprivation is associated with increased mortality from cardiovascular causes and malignancy. The influence of disadvantage in patients with rheumatoid arthritis (RA), who are known to have premature mortality, has not been ascertained.AIM To assess the relation between the level of patient deprivation and mortality in RA patients.METHODS 200 RA patients, enrolled in a study comparing sulfasalazine and penicillamine in 1984–85, have been followed up prospectively for 12 years. Subjects were categorised into Carstairs groups with deprivation scores ranging from 1 (most affluent) to 7 (most deprived). Information about deaths was obtained from the Registrar General in Scotland, death certificates and GP/hospital records.RESULTS There were more RA patients in the deprived areas then expected compared with the West of Scotland and England and Wales. Some 47.5% of the RA patients had died by 12 years—the majority of cardiorespiratory causes or malignancy. There were no differences in the median age or disease duration in the various Carstairs groups at study entry, but the percentage of deaths was higher in the more deprived groups after 12 years (36% dead in most affluent area compared with 61% in the most deprived, that is, in groups 6 and 7).CONCLUSION In patients with RA increasing deprivation was associated with premature mortality. If confirmed elsewhere these findings have implications for rheumatological management strategies, for researchers involved in collaborative studies of patients from different socioeconomic backgrounds and for resource allocation.