脆弱性会增加类风湿性关节炎中死亡的风险
Sayuli A Bhide1, Punyasha Roul2, Bryant R England3
1VA Puget Sound Health Care System, Seattle, WA, USA; University of Washington, Seattle, WA, USA.
Seminars in arthritis and rheumatism
|November 13, 2025
概括
类风湿性关节炎 (RA) 中的脆弱性显著增加了死亡风险,较高的脆弱性水平与较短的生存时间相关. 发病率和功能障碍是RA患者这种风险增加的关键驱动因素.
科学领域:
- 类风湿病学 类风湿病学
- 老年学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 在类风湿性关节炎 (RA) 患者中,虚弱是常见的.
- 脆弱性是不良结果的已知风险因素.
- 在RA中脆弱性和死亡率之间的联系尚未完全理解.
研究的目的:
- 在风湿性关节炎队列中调查脆弱性和死亡率之间的关联.
- 确定虚弱是否是RA死亡率的独立预测因素.
- 确定有助于死亡风险的特定脆弱领域.
主要方法:
- 利用了退伍军人协会风湿关节炎 (VARA) 注册表 (2003-2020) 的数据.
- 使用VA脆弱指数 (VA-FI) 评估脆弱性,将参与者分为强壮,前脆弱,轻微脆弱和中度/严重脆弱.
- 采用多变量Cox比例危险模型来分析基线脆弱性和死亡率之间的关系,调整共变量.
主要成果:
- 分析了2792名RA退伍军人 (平均年龄64.3,88%男性).
- 随着虚弱程度的严重程度,死亡风险逐步增加:虚弱前 (aHR 1.46),轻度虚弱 (aHR 1.97) 和中度/严重的虚弱 (aHR 2.93).
- 发病率和功能障碍是与死亡率增加最强烈相关的脆弱领域.
结论:
- 较高程度的虚弱与 RA 患者的死亡风险逐步增加和生存率降低有关.
- 发病率和功能障碍显著提高了RA的死亡风险.
- VA脆弱性指数显示为RA患者的预后工具有前途.
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