Similar prediction of mortality by the health assessment questionnaire in patients with RA and the general population

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Ann Rheum Dis. 2004 May;63(5):494-7.

Similar prediction of mortality by the health assessment questionnaire

in patients with rheumatoid arthritis and the general population.

Sokka T, Hakkinen A, Krishnan E, Hannonen P.

Vanderbilt University/Rheumatology, 203 Oxford House, Nashville, TN

37232-4500, USA. tuulikki.sokka@...

BACKGROUND: The self report health assessment questionnaire (HAQ)

quantifies disability in activities of daily living (ADL). In patients

with rheumatoid arthritis, the HAQ predicts mortality, work disability,

and hip replacement surgery. It has been widely used in rheumatology,

but population based data are rare. OBJECTIVE: To determine whether the

HAQ predicts mortality in patients with rheumatoid arthritis (n = 1095)

and community controls (n = 1490). METHODS: A mailed questionnaire

including the HAQ, visual analogue scales for pain and global health,

comorbidities, education level, height, weight, and smoking status was

administered in June 2000. Two years later, the vital status of the

subjects was ascertained from the Finnish Population Register database.

RESULTS: There were 41 deaths (10.1%) among the 404 patients with

rheumatoid arthritis who had a baseline HAQ >/=1 (indicating at least

some difficulty in most ADL), and 16 (2.3%) among 691 patients with HAQ

<1 (p<0.001); in the community controls the values were 20 (13.6%) among

147 with HAQ >/=1, and 14 (1.0%) among 1343 with HAQ <1 (p<0.001). A

higher HAQ score was an independent predictor of mortality in patients

with rheumatoid arthritis (hazard ratio 2.73 (95% confidence interval,

1.86 to 4.02); p<0.001) and in community controls (2.75 (1.61 to 4.70);

p<0.001).

CONCLUSIONS: The HAQ predicts mortality in the community population as

well as in patients with rheumatoid arthritis. People with similar

levels of disability appear to have a similar likelihood of mortality

over two years.

PMID

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Mayo Clinic in Rochester

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