urvival of patients with rheumatoid arthritis compared with the general outpatient population from 2016 to 2026: A retrospective two-center cohort study

Title : urvival of patients with rheumatoid arthritis compared with the general outpatient population from 2016 to 2026: A retrospective two-center cohort study

Abstract:

Background: Rheumatoid arthritis (RA) is associated with chronic systemic inflammation and excess mortality. Contemporary Russian data comparing long-term survival in patients with RA with that of the general outpatient population remain limited.
Objective: To compare all-cause mortality and long-term survival in patients with RA and matched outpatient controls during 2016–2026.
Methods: A retrospective two-center cohort study was conducted in the Sverdlovsk Region, Russian Federation. The RA cohort included 206 patients with a confirmed diagnosis established in 2016–2020. The control cohort comprised 20,600 individuals without RA, matched by sex, age, and year of index outpatient visit at a ratio of 1:100. The primary endpoint was all-cause mortality. Survival was analyzed using life tables, Kaplan–Meier curves, the log-rank test, and Cox proportional hazards regression adjusted for sex and age. Crude mortality rates and the standardized mortality ratio were also calculated.
Results: During follow-up, 48 deaths occurred in the RA cohort and 3,009 in the control cohort. The cumulative risk of death was 23.30% in patients with RA and 14.61% in controls (risk ratio 1.595; 95% CI 1.249–2.038; p=0.00025). Crude mortality rates were 31.72 and 18.94 per 1,000 person-years, respectively. Ten-year cumulative survival was 70.63% in the RA group versus 81.66% in controls (log-rank p=0.000254). After adjustment for sex and age, RA remained independently associated with a higher risk of death (hazard ratio 1.80; 95% CI 1.35–2.40; p=0.00005). The standardized mortality ratio was 1.52 (95% CI 1.12–2.01). Diseases of the circulatory system accounted for 54.17% of deaths among patients with RA.
Conclusion: Patients with RA had substantially lower long-term survival and higher all-cause mortality than matched outpatient controls. The findings support intensified cardiovascular risk assessment, long-term follow-up, and integrated management of comorbidities in routine rheumatology care.
Keywords: Rheumatoid Arthritis; Mortality; Survival Analysis; Epidemiology; Cardiovascular Mortality

Biography:

Nadezhda Mikhailovna Ruslanova is a second-year postgraduate researcher in Internal Medicine at Ural State Medical University, Russian Federation. Her research focuses on rheumatoid arthritis, long-term survival, mortality, clinical epidemiology, and cardiovascular risk in patients with chronic inflammatory rheumatic diseases. She is involved in retrospective cohort research using survival analysis, including Kaplan–Meier methods, Cox regression, and standardized mortality estimates, with the aim of improving risk assessment and long-term patient management in routine clinical practice.