To assess mortality, causes of death, and patient and disease characteristics predicting survival in a 5 year followup of a community based population of 103 patients with rheumatoid arthritis (RA) in the Kuusamo community in Northern Finland.
Mortality and causes of death were assessed on the basis of official data registers and death certificates. The relation of different baseline patient demographics and disease characteristics to mortality was evaluated.
Functional status, measured by the lower extremity component of the Keitel function test, emerged as the most powerful factor predicting mortality. A poor lower extremity function (score > or = 13) increased the relative risk of death (hazard ratio 9.1) compared to well preserved lower extremity function. If the Keitel function test was omitted from the survival analysis, the best predictor of mortality was the Health Assessment Questionnaire. Twenty-one percent of the patients had died during the followup, the most usual cause of death being cardiovascular disease.
Poor functional status, measured in this series by the Keitel function test, is a powerful predictor of mortality in RA. Our results confirm the importance of measurement of functional status in rheumatology care.