van Dijk Gabriella M, Veenhof Cindy, Schellevis Francois, Hulsmans Harry, Bakker Jan Pj, Arwert Henk, Dekker Jos Hm, Lankhorst Guus J, Dekker Joost
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
BMC Musculoskelet Disord. 2008 Jun 26;9:95. doi: 10.1186/1471-2474-9-95.
This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity.
A cross-sectional cohort study was conducted, in which 288 elderly patients with hip or knee osteoarthritis were included. Apart from demographic and clinical data, information about comorbidity, limitations in activities (WOMAC, SF-36 and timed walking test) and pain (VAS) was collected by questionnaires and tests. Statistical analyses included descriptive statistics, multivariate regression techniques, t-tests and one-way ANOVA.
Almost all patients suffered from at least one comorbid disease, with cardiac diseases, diseases of eye, ear, nose, throat and larynx, other urogenital diseases and endocrine/metabolic diseases being most prevalent. Morbidity count and severity index were associated with more limitations in activities and with more pain. The presence of most of the moderate or severe diseases and obesity was associated with limitations in activities or with pain.
The results of this study emphasize the importance of comorbidity in the rehabilitation of elderly patients with osteoarthritis of the hip or knee. Clinical practitioners should be aware of the relationship of comorbidity with functional problems in OA patients.
本研究旨在增进对合并症在骨关节炎中影响的认识。该研究的目的是:(i)描述合并症的患病率;(ii)使用一份全面的合并症清单,描述老年髋或膝骨关节炎患者的合并症(发病计数、严重程度和特定疾病的存在情况)与活动受限及疼痛之间的关系。
进行了一项横断面队列研究,纳入了288例老年髋或膝骨关节炎患者。除人口统计学和临床数据外,通过问卷调查和测试收集了有关合并症、活动受限(WOMAC、SF - 36和定时步行测试)及疼痛(视觉模拟评分法)的信息。统计分析包括描述性统计、多元回归技术、t检验和单因素方差分析。
几乎所有患者都患有至少一种合并症,其中心脏病、眼耳鼻喉及喉疾病、其他泌尿生殖系统疾病和内分泌/代谢疾病最为常见。发病计数和严重程度指数与更多的活动受限及更多的疼痛相关。大多数中度或重度疾病以及肥胖的存在与活动受限或疼痛相关。
本研究结果强调了合并症在老年髋或膝骨关节炎患者康复中的重要性。临床医生应意识到合并症与骨关节炎患者功能问题之间的关系。