Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Life Expectancy, Standardized Mortality Ratios and Causes of Deaths of Six Rheumatic Diseases in Hong Kong, China.

Mok1,  Chi Chiu, Kwok2,  Raymond C. L., Ho1,  Ling Yin, Chan1,  Pak To, Yip2,  Paul S. F.

Tuen Mun Hospital
University of Hong Kong

Objectives:

To study the life expectancy, standardized mortality ratios (SMRs) and causes of deaths of six rheumatic diseases in Hong Kong

Methods:

The number of patients with the International Classification of Disease (ICD)-9 diagnostic codings of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PSA), systemic vasculitides (SV) and systemic sclerosis (SSc) who were followed in our hospital between year 1999 and 2008 were retrieved by the hospital registry called the Clinical Data Analysis and Reporting System (CDARS). The number of patients with these disease codings who died during follow-up was also retrieved by the hospital death registry. The SMRs were calculated by comparing the rate of mortality of each disease entity (observed deaths) with the mortality rate of the general population gathered from the population census and the general death registry (expected deaths). The causes of death were evaluated and compared across these six rheumatic diseases. Life expectancy of each disease was calculated by abridged life table analysis using the prevalence and death data in the CDARS and data reported for the Hong Kong population within the same study period.

Results:

The causes of deaths of 348 patients between year 1999 and 2008 were analyzed. The distribution of the underlying diseases was: RA (50%), SLE (23%), SV (14%), AS (7%), SSc (4%) and PSA (1%). The mean age at the time of death was 65.5±17.3 years and 240 patients (69%) were women. The age at death was highest with RA (74.1±12.1 years) and lowest with SLE (49.0±15.7 years). The mean SMR of both sexes and all age groups was highest for SLE (24.3 [22.2–26.4]), followed by SSc (18.3 [15.3–22.1]), SV (11.1 [9.9–12.3]), AS (8.8 [7.6–10.3]), RA (8.3 [7.9–8.8]) and PSA (7.5 [5.7–9.8]). The principle causes of deaths were, in descending order of frequency, infections (34%), cancers (18%), cardiovascular / cerebrovascular complications (16%), renal failure (6%), pulmonary pathologies (4%), liver and gastrointestinal complications (4%), accidents (1%) and suicide (1%). Infections were the commonest cause of death in SLE, RA and AS but not in other three diseases. Cardiovascular death was most frequent in patients with SSc and PSA. Cancer deaths were highest in patients with SV, followed by PSA and AS. Renal failure as a cause of death was reported in SLE and RA only. Cases of suicide occurred exclusively in SLE. In female patients, the loss in life expectancy was greatest with SSc (34.1 years), followed by SV (19.3 years), SLE (19.7 years), RA (6.9 years), PSA (6.5 years) and AS (1.2 years). In male patients, the loss in life expectancy was greatest with SV (28.3 years), followed by SLE (27 years), SSc (16 years), AS (7 years) and RA (5.2 years).

Conclusions:

Patients with rheumatic diseases have a higher mortality risk than the general population, leading to a significant loss in life expectancy. Among the six diseases studied, SLE has the highest SMR and female SSc patients had the greatest loss in life expectancy. Infection is the commonest cause of death in SLE, RA and AS; but cancer is the leading cause of death in SV. Cardiovascular deaths are more common in patients with SSc and AS.

To cite this abstract, please use the following information:
Mok, Chi Chiu, Kwok, Raymond C. L., Ho, Ling Yin, Chan, Pak To, Yip, Paul S. F.; Life Expectancy, Standardized Mortality Ratios and Causes of Deaths of Six Rheumatic Diseases in Hong Kong, China. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :773
DOI: 10.1002/art.28541

Abstract Supplement

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