Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
Department of Physiotherapy, Rehabilitation Centre, Ryhov County Hospital, Jönköping, Sweden.
BMJ Open. 2021 Sep 13;11(9):e049476. doi: 10.1136/bmjopen-2021-049476.
To describe the prevalence of comorbidities in a population referred to standardised first-line intervention (patient education and exercise) for hip and knee osteoarthritis (OA), in comparison with the general population. Furthermore, we aimed to evaluate if eventual differences were associated with socioeconomic inequalities.
Register-based study.
Primary healthcare, Sweden.
Individuals with hip and/or knee OA included in the Better Management for Patients with Osteoarthritis Register between 2008 and 2016 and and an age-matched, sex-matched and residence-matched reference cohort (1:3) from the general Swedish population.
Comorbidities were identified with the RxRisk Index, the Elixhauser Comorbidity Index and the Charlson Comorbidity Index, and presented with descriptive statistics as (1) individual diseases, (2) disease categories and (3) scores for each index. The prevalence of comorbidities in the two populations was tested using logistic regression, with separate analyses for age groups and the most affected joint. We then adjusted the analyses for socioeconomic status.
In this OA population, 85% had ≥1 comorbidity compared with 78% of the reference cohort (OR; 1.62 (95% CI 1.59 to 1.66)). Cardiovascular/blood diseases were the most common comorbidities in both populations (OA, 59%; reference, 54%), with OR; 1.22 (95% CI 1.20 to 1.24) for the OA population. Younger individuals with OA were more comorbid than their matched references overall, and population differences decreased with age (eg, ≥3 comorbidities, aged ≤45 years OR; 1.74 (95% CI 1.52 to 1.98), ≥81 years OR; 0.95 (95% CI 0.87 to 1.04)). Individuals with knee OA were more comorbid than those with hip OA overall. Adjustment for socioeconomic status did not change the estimates.
Comorbidities were more common among individuals with hip and knee OA than among matched references from the general population. The differences could not be explained by socioeconomic status.
NCT03438630.
描述接受髋关节和膝关节骨关节炎（OA）标准一线干预（患者教育和运动）的人群中合并症的流行情况，并与普通人群进行比较。此外，我们旨在评估这些差异是否与社会经济不平等有关。
基于登记的研究。
初级保健，瑞典。
2008 年至 2016 年期间纳入 Better Management for Patients with Osteoarthritis 登记处的髋关节和/或膝关节 OA 患者，以及来自普通瑞典人群的年龄、性别和居住相匹配的参考队列（1:3）。
使用 RxRisk 指数、Elixhauser 合并症指数和 Charlson 合并症指数识别合并症，并使用描述性统计方法（1）个体疾病、（2）疾病类别和（3）每个指数的评分进行呈现。使用逻辑回归测试两种人群中合并症的患病率，分别对年龄组和受影响最严重的关节进行分析。然后，我们调整了社会经济地位的分析。
在这个 OA 人群中，85%的人有≥1 种合并症，而参考队列中这一比例为 78%（OR；1.62（95%CI 1.59 至 1.66））。心血管/血液疾病是两种人群中最常见的合并症（OA，59%；参考，54%），OA 人群的 OR；1.22（95%CI 1.20 至 1.24）。总体而言，年轻的 OA 患者比他们的匹配参考人群更易合并症，且随着年龄的增长，人群差异会减小（例如，≤45 岁的≥3 种合并症 OR；1.74（95%CI 1.52 至 1.98），≥81 岁 OR；0.95（95%CI 0.87 至 1.04））。总体而言，膝关节 OA 患者比髋关节 OA 患者更易合并症。调整社会经济地位并不能改变这些估计。
髋关节和膝关节 OA 患者的合并症比普通人群中的匹配参考人群更为常见。这些差异不能用社会经济地位来解释。
NCT03438630。
