NIVEL (Netherlands Institute for Health Services Research), Utrecht.
Fam Pract. 2013 Dec;30(6):615-20. doi: 10.1093/fampra/cmt037. Epub 2013 Jul 20.
Little is known about the presence of chronic morbidity in inflammatory arthritis (IA) patients at disease onset. Previous studies have been mainly performed in established IA patients or they focus on isolated co-morbid diseases. Our aim was to determine the prevalence of chronic diseases at the onset of IA and to determine whether this is different from the number that one might expect based on age and sex. Patients and methods. A nested case-control study from 2001 to 2010 using data from patient electronic medical records in general practice. Totally, 3354 patients with newly diagnosed IA were included. Each patient was matched on age, sex and general practice with two control patients. In total, 121 different chronic diseases were studied.
In total, 70% of the IA patients had at least one chronic disease at the onset of IA, compared with 59% of the control patients (P < 0.001). The highest prevalence in IA patients was found for cardiovascular diseases (35%), musculoskeletal diseases (27%) and neurological diseases (22%). Compared with the control patients, patients with IA had the highest increased risk for musculoskeletal diseases [odds ratio, OR = 1.7 (95% confidence interval: 1.6-19)] and for neurological diseases [OR = 1.6 (1.4-1.7)] at the onset of IA.
At the onset of IA, nearly three-quarters of patients with IA had at least one other chronic disease. Since multi-morbidity affects treatment and outcome of the IA patient, these diseases should be taken into account when treating IA patients.
在炎症性关节炎(IA)患者发病时,慢性合并症的存在情况知之甚少。既往研究主要在已确诊的 IA 患者中进行,或者仅关注孤立的合并症疾病。我们的目的是确定 IA 发病时慢性疾病的患病率,并确定其是否与基于年龄和性别预期的数量有所不同。
这是一项 2001 年至 2010 年的巢式病例对照研究,使用普通诊所患者电子病历中的数据。共纳入 3354 例新发 IA 患者。每位患者均根据年龄、性别和普通诊所与两名对照患者进行匹配。共研究了 121 种不同的慢性疾病。
IA 患者中有 70%在发病时至少患有一种慢性疾病,而对照患者中这一比例为 59%(P<0.001)。IA 患者中最常见的慢性疾病是心血管疾病(35%)、肌肉骨骼疾病(27%)和神经系统疾病(22%)。与对照患者相比,IA 患者发病时肌肉骨骼疾病的风险最高[比值比,OR=1.7(95%置信区间:1.6-19)]和神经系统疾病[OR=1.6(1.4-1.7)]。
在 IA 发病时,近四分之三的 IA 患者至少患有另一种慢性疾病。由于多种合并症会影响 IA 患者的治疗和预后,因此在治疗 IA 患者时应考虑这些疾病。