Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada
Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada
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DOI：
10.1136/bmjopen-2019-033334
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发表时间：
2019-11-01
期刊：
影响因子：
2.9
通讯作者：
Lix, Lisa
中科院分区：
文献类型：
--
作者：
Marshall, Deborah A.;Liu, Xiaoxiao;Lix, Lisa
目的本研究的目的是利用行政卫生数据评估骨关节炎(OA)患者的并存患病率。设计回溯性队列分析。设计回溯性队列分析。设置加拿大艾伯塔省所有登记在艾伯塔省医疗保险计划人口登记的居民。参与者497362名患有OA的患者，其定义是在两年内至少有一次与OA相关的住院，或至少两次与OA相关的医生就诊或两次门诊护理访问。主要结果衡量：我们基于文献综述、临床咨询和有效的病例定义，选择了8种合并症，以估计他们在诊断为OA时的频率。使用95%的CI直接标准化方法计算了8种临床相关合并症中每1000人的性别分层年龄标准化患病率。结果符合OA病例定义的54.6%(n=271794)的患者至少有8种选定的并存疾病中的一种。女性合并症的发生率明显高于男性(标化比=1.26，95%可信区间为1.25~1.28)。在年龄标准化后，抑郁症、慢性阻塞性肺疾病(COPD)和高血压在女性和男性中都是最常见的，所有病例中有40%患有这些并存疾病的任何组合。我们观察到不同年龄组之间的合并症百分比有显著差异，最年轻的年龄组(65岁)说明了这一点。结论我们的发现突显了OA患者的高共病发生率，其中抑郁症的年龄标化患病率最高。合并症对女性的影响不同，而且随着年龄的变化而不同。这些因素应该影响医疗保健计划和服务的提供。
Objectives The purpose of this study is to estimate the prevalence of comorbidities among people with osteoarthritis (OA) using administrative health data. Design Retrospective cohort analysis.Design Retrospective cohort analysis.Setting All residents in the province of Alberta, Canada registered with the Alberta Health Care Insurance Plan population registry.Participants 497362 people with OA as defined by `having at least one OA-related hospitalization, or at least two OA-related physician visits or two ambulatory care visits within two years'.Primary outcome measures We selected eight comorbidities based on literature review, clinical consultation and the availability of validated case definitions to estimate their frequencies at the time of diagnosis of OA. Sex-stratified age-standardised prevalence rates per 1000 population of eight clinically relevant comorbidities were calculated using direct standardisation with 95% CIs. We applied chi(2) tests of independence with a Bonferroni correction to compare the percentage of comorbid conditions in each age group.Results 54.6% (n=2 71 794) of people meeting the OA case definition had at least one of the eight selected comorbidities. Females had a significantly higher rate of comorbidities compared with males (standardised rates ratio=1.26, 95% CI 1.25 to 1.28). Depression, chronic obstructive pulmonary disease (COPD) and hypertension were the most prevalent in both females and males after age-standardisation, with 40% of all cases having any combination of these comorbidities. We observed a significant difference in the percentage of comorbidities among age groups, illustrated by the youngest age group (65 years.Conclusions Our findings highlight the high frequency of comorbidity in people with OA, with depression having the highest age-standardised prevalence rate. Comorbidities differentially affect females, and vary by age. These factors should inform healthcare programme and delivery.