Causes of death in patients with rheumatoid arthritis autopsied during a 40-year period
We studied causes of death (CoDs) between 1952 and 1991 assessed by a clinician before autopsy and then determined at autopsy by a pathologist in 369 subjects with rheumatoid arthritis (RA) and 370 subjects without RA (non-RA). We analysed clinical data for RA subjects between 1973 and 1991. In RA s...
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| Veröffentlicht in: | Rheumatology international 2008-10, Vol.28 (12), p.1245-1252 |
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| creator | Koivuniemi, R. Paimela, L. Suomalainen, R. Piirainen, H. Karesoja, M. Helve, T. Leirisalo-Repo, M. |
| description | We studied causes of death (CoDs) between 1952 and 1991 assessed by a clinician before autopsy and then determined at autopsy by a pathologist in 369 subjects with rheumatoid arthritis (RA) and 370 subjects without RA (non-RA). We analysed clinical data for RA subjects between 1973 and 1991. In RA subjects, leading autopsy-based CoDs were RA, cardiovascular diseases and infections. Between diagnoses of CoDs by the clinician and those determined by the pathologist, RA subjects had lower agreement than did the non-RA regarding coronary deaths (Kappa reliability measure: 0.33 vs. 0.46). In non-RA subjects, autopsy-based coronary deaths showed a decline since the 1970s with no such decline in RA. Between subjects treated at any time during RA with disease-modifying anti-rheumatic drugs and those without, autopsy-based CoDs were similar. Coronary death being less accurately diagnosed in RA subjects may indicate that coronary heart disease in RA patients often remains unrecognized. |
| doi_str_mv | 10.1007/s00296-008-0685-6 |
| format | Article |
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We analysed clinical data for RA subjects between 1973 and 1991. In RA subjects, leading autopsy-based CoDs were RA, cardiovascular diseases and infections. Between diagnoses of CoDs by the clinician and those determined by the pathologist, RA subjects had lower agreement than did the non-RA regarding coronary deaths (Kappa reliability measure: 0.33 vs. 0.46). In non-RA subjects, autopsy-based coronary deaths showed a decline since the 1970s with no such decline in RA. Between subjects treated at any time during RA with disease-modifying anti-rheumatic drugs and those without, autopsy-based CoDs were similar. 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We analysed clinical data for RA subjects between 1973 and 1991. In RA subjects, leading autopsy-based CoDs were RA, cardiovascular diseases and infections. Between diagnoses of CoDs by the clinician and those determined by the pathologist, RA subjects had lower agreement than did the non-RA regarding coronary deaths (Kappa reliability measure: 0.33 vs. 0.46). In non-RA subjects, autopsy-based coronary deaths showed a decline since the 1970s with no such decline in RA. Between subjects treated at any time during RA with disease-modifying anti-rheumatic drugs and those without, autopsy-based CoDs were similar. Coronary death being less accurately diagnosed in RA subjects may indicate that coronary heart disease in RA patients often remains unrecognized.</description><subject>Aged</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - mortality</subject><subject>Autopsy</subject><subject>Cardiovascular disease</subject><subject>Case-Control Studies</subject><subject>Cause of Death - trends</subject><subject>Coronary Disease - mortality</subject><subject>Female</subject><subject>Finland - epidemiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Registries</subject><subject>Rheumatoid arthritis</subject><subject>Rheumatology</subject><issn>0172-8172</issn><issn>1437-160X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kE1LxDAQhoMoun78AC8SPHiLTj6apEdZ_ALBi6K3kDapG9lta5Ii_nuz7IIgeMmQ4Zl3hgehUwqXFEBdJQBWSwKgCUhdEbmDZlRwRaiEt100A6oY0eU5QIcpfUD5Swn76IBqRaXSMEOvczsln_DQYedtXuDQ49Hm4Puc8Fcojbjw08rmIThsY17EkEPCdsrDmIJ32E0x9O_YYgHk29uIRx_D4I7RXmeXyZ9s6xF6ub15nt-Tx6e7h_n1I2m5rDMRTLrOVU561ijGrW3KWXXTVoJL24hK6U4r1wjruG5l1bkWlGNCdUJa39KaH6GLTe4Yh8_Jp2xWIbV-ubS9H6ZkZF1xrjgU8PwP-DFMsS-3Ga0FZYoxXSC6gdo4pBR9Z8YYVjZ-GwpmrdxslJui3KyVG1lmzrbBU7Py7ndi67gAbAOkca3Kx9_N_6f-AC50jCg</recordid><startdate>20081001</startdate><enddate>20081001</enddate><creator>Koivuniemi, R.</creator><creator>Paimela, L.</creator><creator>Suomalainen, R.</creator><creator>Piirainen, H.</creator><creator>Karesoja, M.</creator><creator>Helve, T.</creator><creator>Leirisalo-Repo, M.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20081001</creationdate><title>Causes of death in patients with rheumatoid arthritis autopsied during a 40-year period</title><author>Koivuniemi, R. ; 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We analysed clinical data for RA subjects between 1973 and 1991. In RA subjects, leading autopsy-based CoDs were RA, cardiovascular diseases and infections. Between diagnoses of CoDs by the clinician and those determined by the pathologist, RA subjects had lower agreement than did the non-RA regarding coronary deaths (Kappa reliability measure: 0.33 vs. 0.46). In non-RA subjects, autopsy-based coronary deaths showed a decline since the 1970s with no such decline in RA. Between subjects treated at any time during RA with disease-modifying anti-rheumatic drugs and those without, autopsy-based CoDs were similar. Coronary death being less accurately diagnosed in RA subjects may indicate that coronary heart disease in RA patients often remains unrecognized.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>18716780</pmid><doi>10.1007/s00296-008-0685-6</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - mortality Autopsy Cardiovascular disease Case-Control Studies Cause of Death - trends Coronary Disease - mortality Female Finland - epidemiology Humans Male Medicine Medicine & Public Health Middle Aged Original Paper Registries Rheumatoid arthritis Rheumatology |
| title | Causes of death in patients with rheumatoid arthritis autopsied during a 40-year period |
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