Association of Somatic Comorbidities and Comorbid Depression With Mortality in Patients With Rheumatoid Arthritis

A 14-Year Prospective Cohort Study

J. van den Hoek*, H.C. Boshuizen, L.D. Roorda, G.J. Tijhuis, M.T. Nurmohamed, J. Dekker, G.A.M. van den Bos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)

Abstract

Objective: Patients with rheumatoid arthritis (RA) have a significantly increased risk of mortality compared with the general population. One of the most important predictors for mortality is somatic comorbidity. Moreover, studies have demonstrated that comorbid depression is associated with mortality. Which specific comorbidities are associated with mortality is less investigated. The purpose of this study was to investigate the association of a wide range of comorbidities with mortality in patients with RA. Methods: Longitudinal data over a 14-year period were collected from 882 patients with RA. Data were assessed with questionnaires. The mortality status was obtained from the Statistics Netherlands for the period 1996–2011 for 99% of the patients. Somatic comorbidity was assessed in 1997, 1998, 1999, and 2008 and measured by a national population-based questionnaire including 20 chronic diseases. Comorbid depression was assessed in 1997, 1998, and 1999 and measured with the Center for Epidemiologic Studies Depression Scale. Cox regression was used to study the relationship between comorbidity and mortality. Results: At baseline, 72% of the patients were women. The mean ± SD age was 59.3 ± 14.8 years, and the median (interquartile range) disease duration was 5.0 (2.0–14.0) years. A total of 345 patients died during the study period. Comorbidities that were associated with mortality were circulatory conditions (hazard ratio [HR] 1.60 [95% confidence interval (95% CI) 1.15–2.22]), respiratory conditions (HR 1.43 [95% CI 1.09–1.89]), cancer (HR 2.00 [95% CI 1.28–3.12]), and depression (HR 1.35 [95% CI 1.06–1.72]). Conclusion: Comorbid circulatory conditions, respiratory conditions, cancer, and depression are associated with mortality among patients with RA. Careful monitoring of these comorbidities during the course of the disease and adequate referral may improve health outcomes and chances of surviving.

Original languageEnglish
Pages (from-to)1055-1060
JournalArthritis Care & Research
Volume68
Issue number8
DOIs
Publication statusPublished - 2016

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Comorbidity
Rheumatoid Arthritis
Cohort Studies
Prospective Studies
Mortality
Confidence Intervals
Netherlands
Population
Epidemiologic Studies
Neoplasms
Chronic Disease
Referral and Consultation
Health

Cite this

van den Hoek, J. ; Boshuizen, H.C. ; Roorda, L.D. ; Tijhuis, G.J. ; Nurmohamed, M.T. ; Dekker, J. ; van den Bos, G.A.M. / Association of Somatic Comorbidities and Comorbid Depression With Mortality in Patients With Rheumatoid Arthritis : A 14-Year Prospective Cohort Study. In: Arthritis Care & Research. 2016 ; Vol. 68, No. 8. pp. 1055-1060.
@article{c2efa425290a4f5bbf1391025b5bf9d4,
title = "Association of Somatic Comorbidities and Comorbid Depression With Mortality in Patients With Rheumatoid Arthritis: A 14-Year Prospective Cohort Study",
abstract = "Objective: Patients with rheumatoid arthritis (RA) have a significantly increased risk of mortality compared with the general population. One of the most important predictors for mortality is somatic comorbidity. Moreover, studies have demonstrated that comorbid depression is associated with mortality. Which specific comorbidities are associated with mortality is less investigated. The purpose of this study was to investigate the association of a wide range of comorbidities with mortality in patients with RA. Methods: Longitudinal data over a 14-year period were collected from 882 patients with RA. Data were assessed with questionnaires. The mortality status was obtained from the Statistics Netherlands for the period 1996–2011 for 99{\%} of the patients. Somatic comorbidity was assessed in 1997, 1998, 1999, and 2008 and measured by a national population-based questionnaire including 20 chronic diseases. Comorbid depression was assessed in 1997, 1998, and 1999 and measured with the Center for Epidemiologic Studies Depression Scale. Cox regression was used to study the relationship between comorbidity and mortality. Results: At baseline, 72{\%} of the patients were women. The mean ± SD age was 59.3 ± 14.8 years, and the median (interquartile range) disease duration was 5.0 (2.0–14.0) years. A total of 345 patients died during the study period. Comorbidities that were associated with mortality were circulatory conditions (hazard ratio [HR] 1.60 [95{\%} confidence interval (95{\%} CI) 1.15–2.22]), respiratory conditions (HR 1.43 [95{\%} CI 1.09–1.89]), cancer (HR 2.00 [95{\%} CI 1.28–3.12]), and depression (HR 1.35 [95{\%} CI 1.06–1.72]). Conclusion: Comorbid circulatory conditions, respiratory conditions, cancer, and depression are associated with mortality among patients with RA. Careful monitoring of these comorbidities during the course of the disease and adequate referral may improve health outcomes and chances of surviving.",
author = "{van den Hoek}, J. and H.C. Boshuizen and L.D. Roorda and G.J. Tijhuis and M.T. Nurmohamed and J. Dekker and {van den Bos}, G.A.M.",
year = "2016",
doi = "10.1002/acr.22812",
language = "English",
volume = "68",
pages = "1055--1060",
journal = "Arthritis Care & Research",
issn = "2151-464X",
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Association of Somatic Comorbidities and Comorbid Depression With Mortality in Patients With Rheumatoid Arthritis : A 14-Year Prospective Cohort Study. / van den Hoek, J.; Boshuizen, H.C.; Roorda, L.D.; Tijhuis, G.J.; Nurmohamed, M.T.; Dekker, J.; van den Bos, G.A.M.

In: Arthritis Care & Research, Vol. 68, No. 8, 2016, p. 1055-1060.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Association of Somatic Comorbidities and Comorbid Depression With Mortality in Patients With Rheumatoid Arthritis

T2 - A 14-Year Prospective Cohort Study

AU - van den Hoek, J.

AU - Boshuizen, H.C.

AU - Roorda, L.D.

AU - Tijhuis, G.J.

AU - Nurmohamed, M.T.

AU - Dekker, J.

AU - van den Bos, G.A.M.

PY - 2016

Y1 - 2016

N2 - Objective: Patients with rheumatoid arthritis (RA) have a significantly increased risk of mortality compared with the general population. One of the most important predictors for mortality is somatic comorbidity. Moreover, studies have demonstrated that comorbid depression is associated with mortality. Which specific comorbidities are associated with mortality is less investigated. The purpose of this study was to investigate the association of a wide range of comorbidities with mortality in patients with RA. Methods: Longitudinal data over a 14-year period were collected from 882 patients with RA. Data were assessed with questionnaires. The mortality status was obtained from the Statistics Netherlands for the period 1996–2011 for 99% of the patients. Somatic comorbidity was assessed in 1997, 1998, 1999, and 2008 and measured by a national population-based questionnaire including 20 chronic diseases. Comorbid depression was assessed in 1997, 1998, and 1999 and measured with the Center for Epidemiologic Studies Depression Scale. Cox regression was used to study the relationship between comorbidity and mortality. Results: At baseline, 72% of the patients were women. The mean ± SD age was 59.3 ± 14.8 years, and the median (interquartile range) disease duration was 5.0 (2.0–14.0) years. A total of 345 patients died during the study period. Comorbidities that were associated with mortality were circulatory conditions (hazard ratio [HR] 1.60 [95% confidence interval (95% CI) 1.15–2.22]), respiratory conditions (HR 1.43 [95% CI 1.09–1.89]), cancer (HR 2.00 [95% CI 1.28–3.12]), and depression (HR 1.35 [95% CI 1.06–1.72]). Conclusion: Comorbid circulatory conditions, respiratory conditions, cancer, and depression are associated with mortality among patients with RA. Careful monitoring of these comorbidities during the course of the disease and adequate referral may improve health outcomes and chances of surviving.

AB - Objective: Patients with rheumatoid arthritis (RA) have a significantly increased risk of mortality compared with the general population. One of the most important predictors for mortality is somatic comorbidity. Moreover, studies have demonstrated that comorbid depression is associated with mortality. Which specific comorbidities are associated with mortality is less investigated. The purpose of this study was to investigate the association of a wide range of comorbidities with mortality in patients with RA. Methods: Longitudinal data over a 14-year period were collected from 882 patients with RA. Data were assessed with questionnaires. The mortality status was obtained from the Statistics Netherlands for the period 1996–2011 for 99% of the patients. Somatic comorbidity was assessed in 1997, 1998, 1999, and 2008 and measured by a national population-based questionnaire including 20 chronic diseases. Comorbid depression was assessed in 1997, 1998, and 1999 and measured with the Center for Epidemiologic Studies Depression Scale. Cox regression was used to study the relationship between comorbidity and mortality. Results: At baseline, 72% of the patients were women. The mean ± SD age was 59.3 ± 14.8 years, and the median (interquartile range) disease duration was 5.0 (2.0–14.0) years. A total of 345 patients died during the study period. Comorbidities that were associated with mortality were circulatory conditions (hazard ratio [HR] 1.60 [95% confidence interval (95% CI) 1.15–2.22]), respiratory conditions (HR 1.43 [95% CI 1.09–1.89]), cancer (HR 2.00 [95% CI 1.28–3.12]), and depression (HR 1.35 [95% CI 1.06–1.72]). Conclusion: Comorbid circulatory conditions, respiratory conditions, cancer, and depression are associated with mortality among patients with RA. Careful monitoring of these comorbidities during the course of the disease and adequate referral may improve health outcomes and chances of surviving.

U2 - 10.1002/acr.22812

DO - 10.1002/acr.22812

M3 - Article

VL - 68

SP - 1055

EP - 1060

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 2151-464X

IS - 8

ER -