Bone mineral density in the hand as a predictor for mortality in patients with rheumatoid arthritis
Book C et al. – Findings demonstrate that low digital X-ray radiogrammetry-bone mineral density (DXR-BMD) predicted overall mortality in age- and sex-adjusted analyses; further supporting it as a valid measurement of disease activity or damage and as having prognostic value. Methods- Aim was to evaluate DXR-BMD in the hand as a predictor for all-cause mortality in RA pts
- 152 consecutive pts (78% women, mean disease duration: 14.2 yrs)
- X-rays of the hands at inclusion were available in 108 pts
- Reasons for not evaluating DXR in 24 pts were placement of joint prostheses or severe malalignment
- BMD was evaluated by DXR on the same digitized hand X-rays used for scoring radiographic joint damage
Results- 62 of the 82 pts died, corresponding to a standardized mortality ratio of 2.92 for both sexes combined
- In age- and sex-adjusted proportional hazards models, BMD, Steinbrocker functional class 3-4, the physician's global assessment, and ESR were significant predictors of mortality
- However RF, disease duration, Larsen index, Ritchie articular index and the patient's global assessment were not
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