Does social disadvantage contribute to the excess mortality in rheumatoid arthritis patients?

  • Maiden N
  • Capell H
  • Madhok R
 et al. 
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Background—Socioeconomic deprivation is associated with increased mortality from cardiovascular causes and malig-nancy. The influence of disadvantage in patients with rheumatoid arthritis (RA), who are known to have premature mortal-ity, 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 peni-cillamine in 1984–85, have been followed up prospectively for 12 years. Subjects were categorised into Carstairs groups with deprivation scores ranging from 1 (most aZuent) 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 com-pared with the West of Scotland and Eng-land and Wales. Some 47.5% of the RA patients had died by 12 years—the major-ity of cardiorespiratory causes or malig-nancy. There were no diVerences 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 aZuent area compared with 61% in the most deprived, that is, in groups 6 and 7). Conclusion—In patients with RA increas-ing deprivation was associated with pre-mature mortality. If confirmed elsewhere these findings have implications for rheu-matological management strategies, for researchers involved in collaborative studies of patients from diVerent socio-economic backgrounds and for resource allocation.

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  • N Maiden

  • H A Capell

  • R Madhok

  • R Hampson

  • E A Thomson

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