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Population-Level Influence of Rheumatoid Arthritis on Mortality and Recent Trends: A Multiple Cause-of-Death Analysis in France, 1970-2002 NELLY ZIADÉ, ERIC JOUGLA, and JOEL COSTE
ABSTRACT. Methods. All French death certificates (n = 17,806,923) between 1970 and 2002 were analyzed. Mortality rates related to RA were studied using Poisson regression, and associated causes of death were estimated using the method of observed/expected pairs. Modifications of the International Classification of Diseases and coding methods were considered. Results. RA was mentioned in 0.22% of death certificates. The age-adjusted mortality rates declined during the initial period, but increased in the early 1990s, this trend being driven by the rise in mortality in older groups. The mean age at death was lower for RA-associated deaths than for the general population. Patterns of associated causes of death were identified: there was an increase of the associations with injury, poisoning, external causes, and immunosuppressive toxicities; and a decrease of the associations with endocrine diseases, decubitus ulcers, and glucocorticoid toxicities. Conclusion. RA has a significant impact on mortality in the French population, with a trend toward an increase of associated mortality rates in the older population groups starting in the 1990s. (First Release Sept 15 2008; J Rheumatol 2008;35:1950-7) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Université Paris Descartes, Faculté de Médecine Paris Descartes, AP-HP, Hôpital Cochin, Paris; the National Institute for Health and Medical Research, CépiDc, Paris, France; and the Université Saint-Joseph, Faculté de Médecine, Beyrouth, Liban. N. Ziadé, MD, MPH, Université Paris Descartes, Faculté de Médecine Paris Descartes, Hôpital Cochin; E. Jougla, PhD, National Institute for Health and Medical Research, CépiDc; J. Coste, MD, PhD, Université Paris Descartes, Faculté de Médecine Paris Descartes, Hôpital Cochin. Address reprint requests to Dr. J. Coste, Département de Biostatistique, Pavillon Saint-Jacques, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75674 Paris Cedex 14, France. E-mail: coste@cochin.univ-paris5.fr Accepted for publication May 30, 2008. |
