Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis.
|Title||Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis.|
|Publication Type||Journal Article|
|Year of Publication||2012|
|Authors||Karpouzas GA, Dolatabadi S, Moran R, Li N, Nicassio PM, Weisman MH|
|Journal||Arthritis Care Res (Hoboken)|
|Date Published||2012 Sep|
|Keywords||Adult, Age Factors, Arthritis, Rheumatoid, Cross-Sectional Studies, Depression, Disability Evaluation, Disease Progression, Female, Fibromyalgia, Hispanic Americans, Humans, Linear Models, Los Angeles, Male, Middle Aged, Multivariate Analysis, Pain, Pain Measurement, Predictive Value of Tests, Prevalence, Prognosis, Risk Assessment, Risk Factors, Severity of Illness Index, Surveys and Questionnaires, Time Factors, Vulnerable Populations|
OBJECTIVE: US Hispanics with rheumatoid arthritis experience worse functional outcomes compared to whites. The determinants of disability, however, are not well established in large Hispanic cohorts. In the present report, we identified factors associated with disability in a cross-sectional design, and evaluated their individual contributions to disability over time.
METHODS: Two hundred fifty-one Hispanic subjects from a single center were evaluated. Disease activity, serologies, radiographs, treatments, irreversible articular damage (defined as subluxation, arthrodesis, fusion, or prosthesis), and joint replacement surgeries were recorded. Self-reported disability (Health Assessment Questionnaire disability index), patient pain by a visual analog scale, and depression assessments were collected. Cross-sectional factors associated with disability were identified, and their effects on future disability were evaluated in a subgroup of 114 patients assessed 6 months later.
RESULTS: Six parameters were independently related to disability cross-sectionally: pain was the strongest (P < 0.0001), followed by irreversible articular damage, disease activity, depression, age, and fibromyalgia (P < 0.03 for all). Baseline parameters predicting disability 6 months later included, in decreasing significance, irreversible articular damage (P = 0.004), depression, disease activity, age, and pain (all P < 0.04).
CONCLUSION: In cross-sectional analysis, self-reported pain had the strongest relationship with disability; however, factors such as irreversible articular damage, depression, and disease activity were more important in predicting future disability. Most of these factors are amenable to targeted interventions and should be addressed in an effort to improve functional outcomes.
|Alternate Journal||Arthritis Care Res (Hoboken)|