Predictors of severe self-reported disability in RA in a long-term follow-up study

被引:14
作者
Malm, Karina [1 ,2 ]
Bergman, Stefan [1 ,2 ,3 ]
Andersson, Maria [1 ,2 ]
Bremander, Ann [1 ,2 ,3 ]
机构
[1] Ctr Res & Dev, SE-31392 Spenshult, Oskarstrom, Sweden
[2] Lund Univ, Rheumatol Sect, Dept Clin Sci, Lund, Sweden
[3] Halmstad Univ, Dept Exercise Physiol Biomech & Hlth, Sch Business & Engn, Halmstad, Sweden
关键词
Functioning; pain; prognostic factors; rheumatoid arthritis; EARLY RHEUMATOID-ARTHRITIS; HEALTH-ASSESSMENT QUESTIONNAIRE; PHYSICAL-ACTIVITY; DISEASE-ACTIVITY; TIRA PROJECT; JOINT COUNTS; PREVALENCE; PAIN; ASSOCIATION; REMISSION;
D O I
10.3109/09638288.2014.939773
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Purpose: Identify factors predictive for severe self-reported disability in patients with rheumatoid arthritis. Methods: Patients (n = 1910) were sent a questionnaire 5-18 years after disease onset. Outcomes were the Health Assessment Questionnaire (HAQ), Rheumatoid Arthritis Outcome Score (RAOS) and physical activity. The tertile of patients most affected by the disease were compared to those less affected. Proposed predictive factors were function, pain, general health, radiographic joint damage, swollen/tender joints and disease activity measures at baseline. Age, gender and disease duration were controlled for in logistic regression analyses. Results: Seventy-three percent (n = 1387) responded to the questionnaire, mean age 65 years (SD 15) and 70% were women. Worse scores in function, pain, general health and tender joints at baseline increased the risk of being in the most affected group, as measured by HAQ and RAOS 5-18 years after disease onset (p50.000). Conclusion: High levels of pain and worse reports of function at disease onset were risk factors for being in the most disabled tertile of patients after 5-18 years. Pain and function proved to be predictors of the outcome while some measures of inflammation were not. It is important to recognize these patients who may be in need of multidisciplinary treatments already at disease onset.
引用
收藏
页码:686 / 691
页数:6
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