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Clustering of comorbidities and associated outcomes in people with osteoarthritis - A UK Clinical Practice Research Datalink study

Swain, S. ; Coupland, C. ; Strauss, V. ; Mallen, C. ; Kuo, C. F. ; Sarmanova, A. ; Bierma-Zeinstra, S. M.A. ; Englund, M. LU orcid ; Prieto-Alhambra, D. and Doherty, M. , et al. (2022) In Osteoarthritis and Cartilage 30(5). p.702-713
Abstract

Objective: To examine the clusters of chronic conditions present in people with osteoarthritis and the associated risk factors and health outcomes. Methods: Clinical Practice Research Datalink (CPRD) GOLD was used to identify people diagnosed with incident osteoarthritis (n = 221,807) between 1997 and 2017 and age (±2 years), gender, and practice matched controls (no osteoarthritis, n = 221,807) from UK primary care. Clustering of people was examined for 49 conditions using latent class analysis. The associations between cluster membership and covariates were quantified by odds ratios (OR) using multinomial logistic regression. General practice (GP) consultations, hospitalisations, and all-cause mortality rates were compared across the... (More)

Objective: To examine the clusters of chronic conditions present in people with osteoarthritis and the associated risk factors and health outcomes. Methods: Clinical Practice Research Datalink (CPRD) GOLD was used to identify people diagnosed with incident osteoarthritis (n = 221,807) between 1997 and 2017 and age (±2 years), gender, and practice matched controls (no osteoarthritis, n = 221,807) from UK primary care. Clustering of people was examined for 49 conditions using latent class analysis. The associations between cluster membership and covariates were quantified by odds ratios (OR) using multinomial logistic regression. General practice (GP) consultations, hospitalisations, and all-cause mortality rates were compared across the clusters identified at the time of first diagnosis of osteoarthritis (index date). Results: In both groups, conditions largely grouped around five clusters: relatively healthy; cardiovascular (CV), musculoskeletal-mental health (MSK-MH), CV-musculoskeletal (CV-MSK) and metabolic (MB). In the osteoarthritis group, compared to the relatively healthy cluster, strong associations were seen for 1) age with all clusters; 2) women with the MB cluster (OR 5.55: 5.14–5.99); 3) obesity with the CV-MSK (OR 2.11: 2.03–2.20) and CV clusters (OR 2.03: 1.97–2.09). The CV-MSK cluster in the osteoarthritis group had the highest number of GP consultations and hospitalisations, and the mortality risk was 2.45 (2.33–2.58) times higher compared to the relatively healthy cluster. Conclusions: Of the five identified clusters, CV-MSK, CV, and MSK-MH are more common in OA and CV-MSK cluster had higher health utilisation. Further research is warranted to better understand the mechanistic pathways and clinical implications.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clusters, Comorbidity, Health utilisation, Osteoarthritis, Primary care, UK
in
Osteoarthritis and Cartilage
volume
30
issue
5
pages
702 - 713
publisher
Elsevier
external identifiers
  • scopus:85125130709
  • pmid:35122943
ISSN
1063-4584
DOI
10.1016/j.joca.2021.12.013
language
English
LU publication?
yes
id
9aeb6911-7c4c-4d60-9d67-8b1106f2f830
date added to LUP
2022-04-19 11:23:16
date last changed
2024-06-15 18:37:12
@article{9aeb6911-7c4c-4d60-9d67-8b1106f2f830,
  abstract     = {{<p>Objective: To examine the clusters of chronic conditions present in people with osteoarthritis and the associated risk factors and health outcomes. Methods: Clinical Practice Research Datalink (CPRD) GOLD was used to identify people diagnosed with incident osteoarthritis (n = 221,807) between 1997 and 2017 and age (±2 years), gender, and practice matched controls (no osteoarthritis, n = 221,807) from UK primary care. Clustering of people was examined for 49 conditions using latent class analysis. The associations between cluster membership and covariates were quantified by odds ratios (OR) using multinomial logistic regression. General practice (GP) consultations, hospitalisations, and all-cause mortality rates were compared across the clusters identified at the time of first diagnosis of osteoarthritis (index date). Results: In both groups, conditions largely grouped around five clusters: relatively healthy; cardiovascular (CV), musculoskeletal-mental health (MSK-MH), CV-musculoskeletal (CV-MSK) and metabolic (MB). In the osteoarthritis group, compared to the relatively healthy cluster, strong associations were seen for 1) age with all clusters; 2) women with the MB cluster (OR 5.55: 5.14–5.99); 3) obesity with the CV-MSK (OR 2.11: 2.03–2.20) and CV clusters (OR 2.03: 1.97–2.09). The CV-MSK cluster in the osteoarthritis group had the highest number of GP consultations and hospitalisations, and the mortality risk was 2.45 (2.33–2.58) times higher compared to the relatively healthy cluster. Conclusions: Of the five identified clusters, CV-MSK, CV, and MSK-MH are more common in OA and CV-MSK cluster had higher health utilisation. Further research is warranted to better understand the mechanistic pathways and clinical implications.</p>}},
  author       = {{Swain, S. and Coupland, C. and Strauss, V. and Mallen, C. and Kuo, C. F. and Sarmanova, A. and Bierma-Zeinstra, S. M.A. and Englund, M. and Prieto-Alhambra, D. and Doherty, M. and Zhang, W.}},
  issn         = {{1063-4584}},
  keywords     = {{Clusters; Comorbidity; Health utilisation; Osteoarthritis; Primary care; UK}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{702--713}},
  publisher    = {{Elsevier}},
  series       = {{Osteoarthritis and Cartilage}},
  title        = {{Clustering of comorbidities and associated outcomes in people with osteoarthritis - A UK Clinical Practice Research Datalink study}},
  url          = {{http://dx.doi.org/10.1016/j.joca.2021.12.013}},
  doi          = {{10.1016/j.joca.2021.12.013}},
  volume       = {{30}},
  year         = {{2022}},
}