Correlation between CBC-derived inflammatory indicators and all-cause mortality with rheumatoid arthritis: a...

Area of Science:

• Rheumatology
• Hematology
• Epidemiology

Background:

• Rheumatoid arthritis (RA) is a chronic inflammatory disease with significant impact on patient mortality.
• Inflammatory markers derived from complete blood cell (CBC) counts offer potential for risk stratification.
• Identifying accessible indicators for predicting mortality in RA is crucial for clinical management.

Purpose of the Study:

• To investigate the association between CBC-derived inflammatory indices and all-cause mortality in individuals with RA.
• To evaluate the predictive value of systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) for mortality in RA patients.

Main Methods:

• Utilized data from the National Health and Nutrition Examination Survey (NHANES) database (2007-2018).
• Included 1,314 RA patients with a median follow-up of 78 months.
• Employed multiple COX regression models and restricted cubic spline (RCS) analysis to assess associations between inflammatory indices and all-cause mortality.

Main Results:

• Elevated SIRI, NLR, and MLR were significantly associated with increased all-cause mortality in RA patients (HRs ranging from 1.87 to 1.88 for highest tertiles).
• Kaplan-Meier analysis showed reduced survival probability with higher SIRI, NLR, and MLR levels.
• RCS analysis indicated a linear association between SIRI, NLR, MLR, and mortality, while SII and PLR showed non-linear relationships.

Conclusions:

• SIRI, NLR, and MLR are valuable, convenient inflammatory indicators for assessing mortality risk in US adults with RA.
• Higher levels of SIRI, NLR, and MLR are independently associated with increased long-term mortality.
• These findings support the use of these CBC-derived markers for predicting RA outcomes and informing clinical decision-making.