Rheumatology department, Hotel-Dieu de France Hospital, Beirut, Lebanon.
Rheumatology department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Sci Rep. 2020 May 6;10(1):7683. doi: 10.1038/s41598-020-64732-8.
Increased risk of comorbidities has been reported in Rheumatic and Musculoskeletal Diseases (RMD). We aimed to evaluate the prevalence and pattern of comorbidities in RMD patients nationwide, to identify multimorbidity clusters and to evaluate the gap between recommendations and real screening. Cross-sectional, multicentric nationwide study. Prevalence of comorbidities was calculated according to six EULAR axes. Latent Class Analysis identified multimorbidity clusters. Comorbidities' screening was compared to international and local recommendations. In 769 patients (307 RA, 213 OA, 63 SLE, 103 axSpA, and 83 pSA), the most frequent comorbidities were cardiovascular risk factors and diseases (CVRFD) (hypertension 36.5%, hypercholesterolemia 30.7%, obesity 22.7%, smoking 22.1%, diabetes 10.4%, myocardial infarction 6.6%), osteoporosis (20.7%) and depression (18.1%). Three clusters of multimorbidity were identified: OA, RA and axSpA. The most optimal screening was found for CVRF (> = 93%) and osteoporosis (53%). For malignancies, mammograms were the most optimally prescribed (56%) followed by pap smears (32%) and colonoscopy (21%). Optimal influenza and pneumococcus vaccination were found in 22% and 17%, respectively. Comorbidities were prevalent in RMD and followed specific multimorbidity patterns. Optimal screening was adequate for CVRFD but suboptimal for malignant neoplasms, osteoporosis, and vaccination. The current study identified health priorities, serving as a framework for the implementation of future comorbidity management standardized programs, led by the rheumatologist and coordinated by specialized health care professionals.
风湿和肌肉骨骼疾病(RMD)患者的合并症风险增加已被报道。我们旨在评估全国范围内 RMD 患者的合并症患病率和模式,确定多合并症聚类,并评估建议与实际筛查之间的差距。这是一项横断面、多中心全国性研究。根据六个 EULAR 轴计算合并症的患病率。潜在类别分析确定了多合并症聚类。将合并症的筛查与国际和本地建议进行比较。在 769 名患者(307 名 RA、213 名 OA、63 名 SLE、103 名 axSpA 和 83 名 pSA)中,最常见的合并症是心血管危险因素和疾病(CVRFD)(高血压 36.5%、高胆固醇血症 30.7%、肥胖症 22.7%、吸烟 22.1%、糖尿病 10.4%、心肌梗死 6.6%)、骨质疏松症(20.7%)和抑郁症(18.1%)。确定了三个多合并症聚类:OA、RA 和 axSpA。CVRF(>93%)和骨质疏松症(53%)的筛查效果最佳。对于恶性肿瘤,乳房 X 线摄影是最理想的处方(56%),其次是巴氏涂片(32%)和结肠镜检查(21%)。流感和肺炎球菌疫苗的最佳接种率分别为 22%和 17%。RMD 患者合并症普遍存在,并遵循特定的多合并症模式。CVRFD 的筛查效果最佳,但恶性肿瘤、骨质疏松症和疫苗接种的效果较差。本研究确定了卫生重点,为实施由风湿病学家领导、由专业医疗保健专业人员协调的未来合并症管理标准化计划提供了框架。