Mortality in rheumatoid arthritis.

Rheumatoid arthritis reduces not only quality but also length of life. In the 14 main studies conducted since 1980, in a total of 13,424 patients, the mean standardized mortality ratio was 1.82 (range, 0.87-3) as compared to the population at large. Life expectancy was shortened by 5 to 10 years in most studies. The diversity of the methods used explains the discrepancies among results. Excess mortality may occur in only some subsets of patients. Both rheumatoid complications and an increase in nonspecific causes of death (e.g., infections) contribute to the excess mortality. Factors predictive of premature death are the same as those predictive of functional impairment. Many unknowns remain about the condition of rheumatoid arthritis patients at the end of their life.