Correlation of Naples prognostic score with the risk of all-cause and cardiovascular mortality in individuals with rheumatoid arthritis: A cross-sectional analysis of the NHANES 2001–2018

Objectives

This study seeks to assess how the Naples Prognostic Score (NPS) correlates with mortality in individuals with RA.

Methods

This study assessed the National Health and Nutrition Examination Survey (NHANES) database spanning from 2001 to 2018. NPS was computed utilizing serum albumin (SA), total cholesterol (TC), neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR). A self-administered questionnaire was utilized to gather data from individuals with RA, and the national death index was adopted to determine death rates. Weighted multivariate Cox regression evaluation and Kaplan–Meier survival curve assessment were carried out to explore the correlation of NPS with RA mortality risk, and subgroup analysis and sensitivity analysis were performed to investigate the robustness of the correlation.

Results

Altogether 1683 individuals with RA were enrolled in this research. In the Kaplan–Meier analysis, notable survival discrepancies were observed among various groups in all-cause and cardiovascular (CV) mortality events (P < 0.001). Following adjustment for all confounders, Group 3 (NPS = 3–4) exhibited a markedly heightened likelihood of all-cause mortality by 2.04 times (hazard ratio [HR] = 2.04, 95% confidence interval [CI]: 1.21–3.05, P < 0.01) and CV mortality by 3.59 times (HR = 3.59, 95%CI: 1.24–10.4, P < 0.05) in comparison to Group 1 (NPS = 0). Subgroup analysis and sensitivity analysis indicated that the results were robust.

Conclusion

In the US population, NPS shows a significantly positive correlation with the likelihood of all-cause and CV mortality in individuals with RA. The integration of the NPS into clinical decision-making can offer a more dependable evaluation of the prognosis of individuals with RA.