Factors Associated with Disease Severity in Rheumatoid Arthritis Patients at Phra Nakhon Si Ayutthaya Hospital
Keywords:
Rheumatoid arthritis, Factor, DAS28, DisabilityAbstract
Background: Rheumatoid arthritis is the most common chronic arthritis. Effective treatment requires a timely and accurate diagnosis, and administration of anti-rheumatic drugs to modulate the disease. Therefore, it is important to validate associated factors in order to monitor the rapid progression and reduce the complications of the disease.
Methodology: This research is a cross-sectional study, based on data from medical records involving patients with rheumatoid arthritis in Phra Nakhon Si Ayutthaya hospital during 2018-2020. The outcomes were evaluated by the Disease Activity Score with 28 joint counts (DAS28) criteria to categorize patients into two groups as: (a) patients with extremely severe conditions which indicated a severe disease activity (b) patients with inactive, mildly or moderately severe disease which denotes a better disease activity and then analyze the factors influencing the severity of rheumatoid arthritis.
Result: 88 patients were enrolled in this study. There were 32 patients (36.36%) in severe disease activity and the remaining 56 patients (63.63%) were classified as having better disease activity. Baseline characteristics were not significantly different between two groups. The mean period of onset was less in the better disease activity group (3.3 months vs. 5.4 months). In the severe disease activity group, elbow inflammation was more common than another group. Extra-articular symptoms were more frequent in the severe disease activity group. Hematologic symptoms was more common in the severe disease activity group. Rheumatoid factor was positive, the joint erosion was detected more frequently and the mean ESR was higher in the severe disease activity group. In the multivariate analysis, patients with severe disease activity tended to have elbow inflammation, extra articular manifestation especially hematologic symptoms, positive rheumatoid factors, and erosive joint findings on diagnostic radiographs.
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