Correlates and predictors of disability in vulnerable United States Hispanics with rheumatoid arthritis

Arthritis Care & Research , 04/09/2012

Karpouzas GA et al. – In cross–sectional analysis, self–reported pain had the strongest relationship with disability; however, factors such as irreversible articular damage, depression and disease activity were more important in predicting future disability. Most of these factors are amenable to targeted interventions and should be addressed in an effort to improve functional outcomes.

Methods

  • Two hundred and fifty one Hispanic subjects from a single center were evaluated.
  • Disease activity, serologies, radiographs, treatments, irreversible articular damage (defined as subluxation, arthrodesis, fusion, or prosthesis) and joint replacement surgeries were recorded.
  • Self–reported disability (Health Assessment Questionnaire Disability Index [HAQ–DI]), patient– pain by visual analogue scale, and depression assessments were collected.
  • Cross–sectional factors associated with disability were identified, and their effects on future disability were evaluated in a subgroup of 114 patients assessed 6 months later.

Results

  • Six parameters were independently related to disability cross–sectionally: pain was the strongest (p<0.0001), followed by irreversible articular damage, disease activity, depression, age, and fibromyalgia (all p<0.03).
  • Baseline parameters predicting disability 6 months later included – in decreasing significance– irreversible articular damage (p=0.004), depression, disease activity, age, and pain (all p<0.04).

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