6Comorbidities in rheumatoid arthritis
Section snippets
Comorbidity and rheumatoid arthritis
A comorbid condition is another medical condition that is present in addition to rheumatoid arthritis (RA). Comorbidity can be further defined in terms of a current (recent) or past condition, and the comorbid condition described might represent an active, past or transient illness. Ongoing interstitial lung disease, previous malignancies and past influenza are respective examples of such states.
In this chapter we cite selectively from the voluminous literature of comorbidity in patients with
Why is comorbidity of interest in rheumatoid arthritis?
Physicians and researchers are interested in comorbidity because of its effect on quality of life (QOL) and on RA prognosis and outcome. Using the NDB index of comorbid conditions (an index of how medically ill the patient is), the number of comorbid conditions is directly related to QOL as measured by the EuroQoL (Figure 1).2, 3 Although it is common to think of functional status in RA as being related primarily to RA, functional status is also strongly influenced by comorbid illness (Figure 2
The evaluation and measurement of comorbidity
Under many circumstances, the number of different comorbid conditions as a measure of comorbidity burden has important prognostic value. For example, individuals with cardiovascular, pulmonary and renal disease have worse prognoses for almost any outcome than individuals with only one of these conditions. This has led to the development of indices that provide a ‘comorbidity score’ (Table 2). As might be obvious, different comorbid conditions have different prognostic values. For example,
Specific comorbid conditions
The associations of specific comorbidities and RA are shown in Table 4.
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