Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK.
Qual Life Res. 2012 May;21(4):581-91. doi: 10.1007/s11136-011-9974-8. Epub 2011 Jul 26.
To investigate the influence of disease severity within cardiovascular disease (CVD) and musculoskeletal (MSK) disorder spectrums on physical health change over 3 years.
Consultation records of 4,672 patients aged 50 years and above from six general practices were linked to their baseline and 3-year Short-Form-12 (SF-12) physical component summary (PCS) scores. Associations between exclusive diagnostic categories and comorbid counts with physical health change over 3 years were examined.
There were 1,371 (29.3%) CVD and 1,972 (42.2%) MSK consulters. Adjusted additional change in PCS scores relative to hypertension ranged from -0.43 (95% confidence interval -2.5, 1.7) for atrial fibrillation to -2.09 (-4.2, 0.0) for heart failure. In the MSK spectrum, changes relative to soft tissue disorder ranged from -0.63 (-3.0, 1.8) for soft tissue pain to -1.09 (-4.1, 2.0) for inflammatory polyarthropathy. A trend in association between increasing disease severity and deterioration in physical health was only observed within the CVD spectrum, and this trend was retained in those with CVD and higher levels of comorbidity.
CVD severity with higher levels of comorbidity was associated with greater relative deterioration in long-term physical health. Such findings were not found for the MSK cohorts, suggesting the differing health impact of different chronic diseases.
研究心血管疾病 (CVD) 和肌肉骨骼 (MSK) 疾病谱内疾病严重程度对 3 年内身体健康变化的影响。
将来自 6 家全科诊所的 4672 名 50 岁及以上患者的就诊记录与他们的基线和 3 年 SF-12 身体成分综合评分 (PCS) 进行关联。检查了排他性诊断类别和共病计数与 3 年内身体健康变化之间的关联。
有 1371 名（29.3%）CVD 和 1972 名（42.2%）MSK 就诊者。与高血压相关的 PCS 评分调整后额外变化范围从房颤的-0.43（95%置信区间-2.5，1.7）到心力衰竭的-2.09（-4.2，0.0）。在 MSK 谱中，与软组织疾病相关的变化范围从软组织疼痛的-0.63（-3.0，1.8）到炎症性多关节炎的-1.09（-4.1，2.0）。仅在 CVD 谱中观察到疾病严重程度与身体健康恶化之间存在关联趋势，而且在 CVD 患者和更高共病水平的患者中保留了这种趋势。
CVD 严重程度和更高水平的共病与长期身体健康相对恶化相关。在 MSK 队列中未发现这种情况，表明不同慢性疾病对健康的影响不同。
