Knee and hip osteoarthritis as predictors of premature death: a review of the evidence.
Knee and hip osteoarthritis as predictors of premature death: a review of the evidence.
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DOI：
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发表时间：
2019-09
影响因子：
3.7
通讯作者：
R. Cleveland;A. Nelson;L. Callahan
中科院分区：
文献类型：
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作者：
R. Cleveland;A. Nelson;L. Callahan
风湿性和肌肉骨骼疾病（RMD）是常见的，其中骨关节炎（OA）是最常见的。RMD，包括OA，与显著疼痛和功能限制相关，死亡率比一般人群高1.6倍。大多数OA和死亡率的研究都集中在膝关节和髋关节OA。这些研究中的一些（但不是全部）表明死亡风险增加，但风险可能因地区而异。不一致结果的原因可能是由于方法学考虑，包括OA的定义、研究设计、随访时间长度，以及随访期间是否重新评估了可能随时间变化和发展的变量，如OA、体重指数（BMI）和合并症的测量。研究表明，在许多方面，OA的预后与类风湿性关节炎（RA）患者相似。在RA中，残疾和合并症是死亡率最重要的预测因素，尽管疼痛在OA死亡率的预后中可能更突出。这些数据表明，解决OA的功能限制和疼痛可能会降低在这些个体中观察到的死亡率增加。需要进一步研究可归因于下半身OA的潜在额外死亡率，以及相关的残疾、疼痛和合并症。
Rheumatic and musculoskeletal diseases (RMDs) are common, with osteoarthritis (OA) being the most prevalent. RMDs, including OA, are associated with significant pain and functional limitations, as well as mortality rates up to 1.6-fold higher than in the general population. Most studies of OA and mortality have focused on knee and hip OA. Some, but not all, of these studies suggest an increased risk of death, however risks may differ by region. Reasons for discordant findings may be due to methodological considerations including definition of OA, study design, length of follow-up, and whether variables that can change and develop over time, such as measures of OA, body mass index (BMI) and comorbidities, were re-assessed during the follow-up period. Research has shown that the prognosis of OA is similar to that seen in rheumatoid arthritis (RA) patients, in many respects. In RA, disability and comorbidities are the most important predictors of mortality, although pain may be more prominent in the prognosis of OA mortality. The data suggest that addressing functional limitations and pain seen with OA could potentially reduce the increased mortality that has been observed in these individuals. Further study is needed concerning the potential excess mortality attributable to lower body OA, as well as associated disability, pain and comorbidities.