Temporal relationship between osteoarthritis and comorbidities : A combined case control and cohort study in the UK primary care setting
(2021) In Rheumatology 60(9). p.4327-4339- Abstract
Objective: To determine the burden of comorbidities in OA and their temporal relationships in the UK. Methods: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidities (two or more comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aORs) and hazard ratios (aHRs), respectively. Results: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities... (More)
Objective: To determine the burden of comorbidities in OA and their temporal relationships in the UK. Methods: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidities (two or more comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aORs) and hazard ratios (aHRs), respectively. Results: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to and following the diagnosis of OA and 2 (dementia and systemic lupus erythematosus) were associated with OA only following the diagnosis of OA. People with OA had a higher risk of developing heart failure [aHR 1.63 (95% CI 1.56, 1.71)], dementia [aHR 1.62 (95% CI 1.56, 1.68)], liver diseases [aHR 1.51 (95% CI 1.37, 1.67)], irritable bowel syndrome [aHR 1.51 (95% CI 1.45, 1.58)], gastrointestinal bleeding [aHR 1.49 (95% CI 1.39, 1.59)], 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95% CI 1.69, 1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95% CI 1.28, 1.30). Conclusions: People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.
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- author
- Swain, Subhashisa ; Coupland, Carol ; Mallen, Christian ; Kuo, Chang Fu ; Sarmanova, Aliya ; Bierma-Zeinstra, Sita M.A. ; Englund, Martin LU ; Prieto-Alhambra, Daniel ; Doherty, Michael and Zhang, Weiya
- organization
- publishing date
- 2021-09-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- burden, comorbidity, multimorbidity, osteoarthritis, temporal association
- in
- Rheumatology
- volume
- 60
- issue
- 9
- pages
- 13 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:33506862
- scopus:85115249045
- ISSN
- 1462-0332
- DOI
- 10.1093/rheumatology/keab067
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology.
- id
- 7af1be97-6aad-436b-a210-19634c1ac436
- date added to LUP
- 2022-02-23 09:12:33
- date last changed
- 2024-04-18 06:00:25
@article{7af1be97-6aad-436b-a210-19634c1ac436, abstract = {{<p>Objective: To determine the burden of comorbidities in OA and their temporal relationships in the UK. Methods: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidities (two or more comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aORs) and hazard ratios (aHRs), respectively. Results: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to and following the diagnosis of OA and 2 (dementia and systemic lupus erythematosus) were associated with OA only following the diagnosis of OA. People with OA had a higher risk of developing heart failure [aHR 1.63 (95% CI 1.56, 1.71)], dementia [aHR 1.62 (95% CI 1.56, 1.68)], liver diseases [aHR 1.51 (95% CI 1.37, 1.67)], irritable bowel syndrome [aHR 1.51 (95% CI 1.45, 1.58)], gastrointestinal bleeding [aHR 1.49 (95% CI 1.39, 1.59)], 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95% CI 1.69, 1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95% CI 1.28, 1.30). Conclusions: People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.</p>}}, author = {{Swain, Subhashisa and Coupland, Carol and Mallen, Christian and Kuo, Chang Fu and Sarmanova, Aliya and Bierma-Zeinstra, Sita M.A. and Englund, Martin and Prieto-Alhambra, Daniel and Doherty, Michael and Zhang, Weiya}}, issn = {{1462-0332}}, keywords = {{burden; comorbidity; multimorbidity; osteoarthritis; temporal association}}, language = {{eng}}, month = {{09}}, number = {{9}}, pages = {{4327--4339}}, publisher = {{Oxford University Press}}, series = {{Rheumatology}}, title = {{Temporal relationship between osteoarthritis and comorbidities : A combined case control and cohort study in the UK primary care setting}}, url = {{http://dx.doi.org/10.1093/rheumatology/keab067}}, doi = {{10.1093/rheumatology/keab067}}, volume = {{60}}, year = {{2021}}, }