Factors associated with disability in patients with rheumatoid arthritis.
OBJECTIVE
Analyze disability determinants in a cohort of Argentine patients with rheumatoid arthritis (RA).


METHODS
Consecutive patients with RA, according to ACR'87 criteria, were recruited from 6 rheumatology centers. Demographic and socioeconomic data, family history, comorbid diseases, extra-articular manifestations and information about received treatments were provided. Disease activity was assessed using Disease Activity Score 28 (DAS 28) and the Health Assessment Questionnaire (HAQ)-A was used for the functional capacity. Hand and feet radiographs were assessed using Sharp-van der Heijde score.


RESULTS
A total of 640 patients with RA were included, of which 85.2% were females. Mean age was 53 years (interquartile range [IQR], 44-62) and mean disease duration was 8 years (IQR, 4-14). DAS 28 mean was 2.72 (IQR, 1.7-3.7) and HAQ-A mean was 0.62 (IQR, 0.13-1.25). Multiple linear regression showed that the main variables associated with disability were DAS 28, radiologic damage and age. Main predictors of functional disability in the multiple logistic regression using severe HAQ (>2) as dependent variable were DAS 28 (OR, 2; P < 0.0001); age (OR, 1; P = 0.008); and structural damage (OR, 1; P = 0.001).


CONCLUSIONS
In this population, the disease activity was the variable that showed the highest impact on the physical function. Radiologic damage affected HAQ as the disease progressed.
Schneeberger
Emilce E
EE
Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina.
Citera
Gustavo
G
Maldonado Cocco
José A
JA
Salcedo
Mariana
M
Chiardola
Flavia
F
Rosemffet
Marcos G
MG
Marengo
María F
MF
Papasidero
Silvia
S
Chaparro Del Moral
Rafael
R
Rillo
Oscar L
OL
Bellomio
Verónica
V
Lucero
Eleonora
E
Spindler
Alberto
A
Berman
Alberto
A
Duartes Noe
Damian
D
Barreira
Juan C
JC
Lázaro
María A
MA
Paira
Sergio O
SO
D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001118:Argentina; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging; D050823:Hand Joints / Q000000981:diagnostic imaging; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index
D018501:Antirheumatic Agents