Larsen Peter, Elsoe Rasmus
Department of Orthopaedic Trauma Surgery, Aalborg University Hospital, 18-22 Hobrovej, DK-9000, Aalborg, Denmark.
Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark.
Clin Rheumatol. 2025 Apr;44(4):1811-1818. doi: 10.1007/s10067-025-07372-5. Epub 2025 Feb 22.
Despite extensive validation, the impact of medical comorbidities on the outcomes of the Hip Disability and Osteoarthritis Outcome Score (HOOS), Knee Injury Osteoarthritis Outcome Score (KOOS), and Foot and Ankle Outcome Score (FAOS) remains underexplored. This study aimed to evaluate the effect of medical comorbidities on HOOS, KOOS, and FAOS subscales using a large, nationally representative sample.
This national register-based cohort study invited 26,877 participants to complete HOOS, KOOS, or FAOS questionnaires. Medical comorbidities-including diabetes, chronic obstructive pulmonary disease/asthma, rheumatological diseases, osteoporosis, stroke, obesity, and heart disease-were identified through the Danish National Patient Register.
A total of 7850 participants (29%) responded, with 1863 (24%) having medical comorbidities. HOOS/KOOS/FAOS subscale scores were significantly worse in patients with comorbidities, particularly in the Sport/Rec, ADL, and QOL subscales. Mean score differences between participants with and without comorbidities were pain (- 5.7, 95% CI - 6.6 to - 4.7), symptoms (- 4.6, 95% CI - 5.5 to - 3.6), ADL (- 7.1, 95% CI - 8.0 to - 6.1), Sport/Rec (- 10.4, 95% CI - 11.9 to - 8.9), and QOL (- 6.9, 95% CI - 8.2 to - 5.7). Diabetes, rheumatological diseases, and obesity were associated with the greatest complaints.
Patients with medical comorbidity reported significantly lower HOOS/KOOS/FAOS subscale scores compared to participants without medical comorbidity. Diabetes, chronic rheumatological diseases, and adiposities were observed with the most complaints. Key Points • Medical comorbidity predicts considerably lower HOOS/KOOS/FAOS subscale scores. • Diabetes, rheumatological diseases, and obesity exerted the most pronounced negative effects on the HOOS/KOOS/FAOS. • Findings underscore the importance of considering comorbidities when interpreting HOOS/KOOS/FOAS subscale scores.
尽管经过了广泛验证，但医学合并症对髋关节残疾和骨关节炎疗效评分（HOOS）、膝关节损伤和骨关节炎疗效评分（KOOS）以及足踝关节疗效评分（FAOS）结果的影响仍未得到充分研究。本研究旨在使用一个具有全国代表性的大样本，评估医学合并症对HOOS、KOOS和FAOS各分量表的影响。
这项基于全国登记的队列研究邀请了26877名参与者完成HOOS、KOOS或FAOS问卷。通过丹麦国家患者登记系统确定医学合并症，包括糖尿病、慢性阻塞性肺疾病/哮喘、风湿性疾病、骨质疏松症、中风、肥胖症和心脏病。
共有7850名参与者（29%）做出回应，其中1863人（24%）患有医学合并症。合并症患者的HOOS/KOOS/FAOS分量表得分明显更差，尤其是在运动/娱乐、日常生活活动（ADL）和生活质量（QOL）分量表中。有合并症和无合并症参与者之间的平均得分差异为疼痛（-5.7，95%置信区间-6.6至-4.7）、症状（-4.6，95%置信区间-5.5至-3.6）、ADL（-7.1，95%置信区间-8.0至-6.1）、运动/娱乐（-10.4，95%置信区间-11.9至-8.9）和QOL（-6.9，95%置信区间-8.2至-5.7）。糖尿病、风湿性疾病和肥胖症与最多的主诉相关。
与无医学合并症的参与者相比，有医学合并症的患者报告的HOOS/KOOS/FAOS分量表得分显著更低。观察到糖尿病、慢性风湿性疾病和肥胖症的主诉最多。要点 • 医学合并症预示着HOOS/KOOS/FAOS分量表得分会显著更低。 • 糖尿病、风湿性疾病和肥胖症对HOOS/KOOS/FAOS产生的负面影响最为明显。 • 研究结果强调在解释HOOS/KOOS/FOAS分量表得分时考虑合并症的重要性。
