Reichmann William M, Katz Jeffrey N, Kessler Courtenay L, Jordan Joanne M, Losina Elena
Brigham and Women's Hospital and Boston University School of Public Health, Boston, Massachusetts 02115, USA.
Arthritis Rheum. 2009 Aug 15;61(8):1046-53. doi: 10.1002/art.24839.
Knee osteoarthritis (OA) is highly prevalent and disabling. Patients with radiographic knee OA may experience pain and functional impairment, which can diminish their health status. Our objective was to determine factors associated with self-reported health status in a national population-based sample with radiographic knee OA.
Our sample included all of the Third National Health and Nutrition Examination Survey (NHANES-III) participants who underwent a knee radiograph and were found to have radiographic OA (defined as Kellgren/Lawrence grade 2 or higher). Self-reported health status was determined by asking the participant to rate their overall health as excellent, very good, good, fair, or poor. Self-reported health status was analyzed as an ordinal variable using cumulative logit regression, as a dichotomous variable (excellent/very good/good versus fair/poor) using logistic regression, and as a continuous variable after transformation using linear regression.
A total of 1,021 (42%) of NHANES-III participants with a knee radiograph were included in this analysis. The multivariable analyses were performed on 1,009 (99%) of the eligible participants with complete data. We found that nonwhite race, lower income, more comorbidities, and greater functional limitation were associated with worse self-reported health status in all 3 multivariable analyses.
This study has quantified the role of clinical, radiographic, and socioeconomic factors associated with self-reported health status in a population-based sample of patients with knee OA. Self-reported health status in patients with knee OA was associated with functional status and comorbidity.
膝关节骨关节炎（OA）极为常见且会导致残疾。膝关节OA影像学检查阳性的患者可能会经历疼痛和功能障碍，这会降低他们的健康状况。我们的目的是在一个基于全国人口的膝关节OA影像学检查阳性样本中，确定与自我报告的健康状况相关的因素。
我们的样本包括所有接受膝关节X线检查且被发现有影像学OA（定义为Kellgren/Lawrence分级2级或更高）的第三次全国健康和营养检查调查（NHANES-III）参与者。通过让参与者将其整体健康状况评为优秀、非常好、好、一般或差来确定自我报告的健康状况。自我报告的健康状况作为一个有序变量，使用累积logit回归进行分析；作为一个二分变量（优秀/非常好/好与一般/差），使用逻辑回归进行分析；并在转换后作为一个连续变量，使用线性回归进行分析。
本分析纳入了1021名（42%）接受膝关节X线检查的NHANES-III参与者。对1009名（99%）有完整数据的合格参与者进行了多变量分析。我们发现，在所有3项多变量分析中，非白人种族、低收入、更多的合并症以及更大的功能限制都与更差的自我报告健康状况相关。
本研究量化了在一个基于人群的膝关节OA患者样本中，与自我报告健康状况相关的临床、影像学和社会经济因素的作用。膝关节OA患者的自我报告健康状况与功能状态和合并症相关。
