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Occurrence of comorbidity following osteoarthritis diagnosis : a cohort study in the Netherlands

Kamps, A. ; Runhaar, J. ; de Ridder, M. A.J. ; de Wilde, M. ; van der Lei, J. ; Zhang, W. ; Prieto-Alhambra, D. ; Englund, M. LU orcid ; de Schepper, E. I.T. and Bierma-Zeinstra, S. M.A. (2023) In Osteoarthritis and Cartilage 31(4). p.519-528
Abstract

Objective: To determine the risk of comorbidity following diagnosis of knee or hip osteoarthritis (OA). Design: A cohort study was conducted using the Integrated Primary Care Information database, containing electronic health records of 2.5 million patients from the Netherlands. Adults at risk for OA were included. Diagnosis of knee or hip OA (=exposure) and 58 long-term comorbidities (=outcome) were defined by diagnostic codes following the International Classification of Primary Care coding system. Time between the start of follow-up and incident diagnosis of OA was defined as unexposed, and between diagnosis of OA and the end of follow-up as exposed. Age and sex adjusted hazard ratios (HRs) comparing comorbidity rates in exposed and... (More)

Objective: To determine the risk of comorbidity following diagnosis of knee or hip osteoarthritis (OA). Design: A cohort study was conducted using the Integrated Primary Care Information database, containing electronic health records of 2.5 million patients from the Netherlands. Adults at risk for OA were included. Diagnosis of knee or hip OA (=exposure) and 58 long-term comorbidities (=outcome) were defined by diagnostic codes following the International Classification of Primary Care coding system. Time between the start of follow-up and incident diagnosis of OA was defined as unexposed, and between diagnosis of OA and the end of follow-up as exposed. Age and sex adjusted hazard ratios (HRs) comparing comorbidity rates in exposed and unexposed patient time were estimated with 99.9% confidence intervals (CI). Results: The study population consisted of 1,890,712 patients. For 30 of the 58 studied comorbidities, exposure to knee OA showed a HR larger than 1. Largest positive associations (HR with (99.9% CIs)) were found for obesity 2.55 (2.29–2.84) and fibromyalgia 2.06 (1.53–2.77). For two conditions a HR < 1 was found, other comorbidities showed no association with exposure to knee OA. For 26 comorbidities, exposure to hip OA showed a HR larger than 1. The largest were found for polymyalgia rheumatica 1.81 (1.41–2.32) and fibromyalgia 1.70 (1.10–2.63). All other comorbidities showed no associations with hip OA. Conclusion: This study showed that many comorbidities were diagnosed more often in patients with knee or hip OA. This suggests that the management of OA should consider the risk of other long-term-conditions.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Comorbidity, Electronic health record (EHR), Osteoarthritis, Primary care
in
Osteoarthritis and Cartilage
volume
31
issue
4
pages
519 - 528
publisher
Elsevier
external identifiers
  • scopus:85146040217
  • pmid:36528309
ISSN
1063-4584
DOI
10.1016/j.joca.2022.12.003
language
English
LU publication?
yes
id
1cc1a215-e592-4f9b-871a-f3c207abc43a
date added to LUP
2023-02-16 15:31:01
date last changed
2024-06-09 10:04:53
@article{1cc1a215-e592-4f9b-871a-f3c207abc43a,
  abstract     = {{<p>Objective: To determine the risk of comorbidity following diagnosis of knee or hip osteoarthritis (OA). Design: A cohort study was conducted using the Integrated Primary Care Information database, containing electronic health records of 2.5 million patients from the Netherlands. Adults at risk for OA were included. Diagnosis of knee or hip OA (=exposure) and 58 long-term comorbidities (=outcome) were defined by diagnostic codes following the International Classification of Primary Care coding system. Time between the start of follow-up and incident diagnosis of OA was defined as unexposed, and between diagnosis of OA and the end of follow-up as exposed. Age and sex adjusted hazard ratios (HRs) comparing comorbidity rates in exposed and unexposed patient time were estimated with 99.9% confidence intervals (CI). Results: The study population consisted of 1,890,712 patients. For 30 of the 58 studied comorbidities, exposure to knee OA showed a HR larger than 1. Largest positive associations (HR with (99.9% CIs)) were found for obesity 2.55 (2.29–2.84) and fibromyalgia 2.06 (1.53–2.77). For two conditions a HR &lt; 1 was found, other comorbidities showed no association with exposure to knee OA. For 26 comorbidities, exposure to hip OA showed a HR larger than 1. The largest were found for polymyalgia rheumatica 1.81 (1.41–2.32) and fibromyalgia 1.70 (1.10–2.63). All other comorbidities showed no associations with hip OA. Conclusion: This study showed that many comorbidities were diagnosed more often in patients with knee or hip OA. This suggests that the management of OA should consider the risk of other long-term-conditions.</p>}},
  author       = {{Kamps, A. and Runhaar, J. and de Ridder, M. A.J. and de Wilde, M. and van der Lei, J. and Zhang, W. and Prieto-Alhambra, D. and Englund, M. and de Schepper, E. I.T. and Bierma-Zeinstra, S. M.A.}},
  issn         = {{1063-4584}},
  keywords     = {{Comorbidity; Electronic health record (EHR); Osteoarthritis; Primary care}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{519--528}},
  publisher    = {{Elsevier}},
  series       = {{Osteoarthritis and Cartilage}},
  title        = {{Occurrence of comorbidity following osteoarthritis diagnosis : a cohort study in the Netherlands}},
  url          = {{http://dx.doi.org/10.1016/j.joca.2022.12.003}},
  doi          = {{10.1016/j.joca.2022.12.003}},
  volume       = {{31}},
  year         = {{2023}},
}