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Risk factors for wrist surgery in rheumatoid arthritis

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Abstract

To assess the risk factors for wrist surgery in a cohort of rheumatoid arthritis (RA) patients recruited and followed prospectively for 6 years. A linked registry study was performed using information from a large observational cohort of RA patients followed at the Institute of Rheumatology, Tokyo Women’s Medical University. Baseline routine clinical and laboratory assessments were recorded. The data were analyzed using the multivariate Cox regression model that included variables such as gender, age, disease duration, a visual analog scale (VAS) generated by physicians, a patient-reported VAS for pain (VAS-pain), a VAS for general health, disability level using the Japanese version of the Health Assessment Questionnaire (J-HAQ), erythrocyte sedimentation rate, and serum levels of C-reactive protein and rheumatoid factor as potential risk factors. Of the 5,497 patients registered at baseline, 122 (2.22%) had surgery on one or both wrist joints. Multivariate Cox regression analysis of the variables revealed positive coefficients for J-HAQ and VAS-pain and that advanced age and long RA duration were associated with a reduced risk of wrist surgery. The hazard ratios were: 1.515 for J-HAQ, 1.126 for VAS-pain, 0.985 for age, and 0.964 for RA duration. Advanced age and long RA duration were associated with a decreased risk of wrist surgery, while J-HAQ and VAS-pain were associated with an increased risk. The identification of the risk factors for wrist surgery provides important insights into the course of the disease and its impact on patients, as well as the potential consequences for health care resource utilization planning.

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Acknowledgements

The authors would like to thank all participating rheumatologists and orthopedic surgeons, and the staff of the IORRA cohort study group. This study was supported by a research grant from 36 pharmaceutical companies for the large observational cohort study of RA at the Institute of Rheumatology, Tokyo Women’s Medical University.

Conflict of interest statement

All listed authors have declared no conflicts of interest.

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All listed authors approved the final version of the manuscript.

All authors affirmed that they have met all three of the criteria for authorship.

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Authors and Affiliations

  1. Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan

    Shigeki Momohara, Eisuke Inoue, Katusnori Ikari, So Tsukahara, Koichiro Kawamura, Hiroe Toki, Masako Hara, Naoyuki Kamatani, Hisashi Yamanaka & Taisuke Tomatsu

  2. Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University, 10–22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan

    Shigeki Momohara

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  1. Shigeki Momohara
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  2. Eisuke Inoue
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  3. Katusnori Ikari
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  4. So Tsukahara
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  5. Koichiro Kawamura
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  6. Hiroe Toki
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  7. Masako Hara
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  8. Naoyuki Kamatani
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  9. Hisashi Yamanaka
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  10. Taisuke Tomatsu
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Correspondence to Shigeki Momohara.

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Momohara, S., Inoue, E., Ikari, K. et al. Risk factors for wrist surgery in rheumatoid arthritis. Clin Rheumatol 27, 1387–1391 (2008). https://doi.org/10.1007/s10067-008-0928-7

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  • DOI: https://doi.org/10.1007/s10067-008-0928-7

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