Social conditions impact functional outcome in patients with hand osteoarthritis: the low-income hand osteoarthritis (LIHOA) cohort.

IF 2 4区医学 Q3 RHEUMATOLOGY

Advances in Rheumatology Pub Date : 2024-10-04 DOI:10.1186/s42358-024-00420-9

Francisco Vileimar Andrade de Azevedo, João Pedro Sobreira Borges, Antonio Matos de Souza Filho, José Carlos Godeiro Costa Junior, Cláudio Régis Sampaio Silveira, Francisco Airton Castro Rocha

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引用次数: 0

Abstract

Background: Hand osteoarthritis (HOA) is a highly prevalent disease that may be impacted by social inequalities. Few studies in HOA are from underdeveloped regions. We intend to contribute to fill this gap presenting clinical characteristics of our low-income HOA cohort (LIHOA).

Methods: Data from 119 patients with a HOA diagnosis fulfilling ACR criteria seen between August 2019 and May 2023 in Fortaleza/Brazil. Evaluations included pain (VAS, visual analogue scale), X-ray (KL, Kellgren-Lawrence), grip and pinch strength (KgF), Cochin hand functional scale (CHFS), FIHOA, and SF-12 scores. Social data included monthly (<1, 1≥/<3, ≥3 MW) minimum wage earnings, occupation, and literacy [

Results: 107 out of the 119 patients were included. Mean age was 61.9 (±10.3) years with 94 (92%) women. Systemic arterial hypertension (48%), metabolic syndrome (42.8%), dyslipidemia (28.4%), and obesity (25%) were the most common comorbidities. Mean disease duration was 7.5 ± 7.1 years. Median VAS values at rest and activity were 3 (3-5) and 8 (5-9), respectively (p < 0.001). Fifty-seven (56.4%) patients had ≥4 symptomatic joints with a median of 4 (2-8) painful joints at activity. The 2nd distal interphalangeal (IF), joint was the most symptomatic (21; 23.3%) and most had >4 IF nodes. OA in other joints: 37 (36.2%) spine, 28 (29.4%) knee, 21 (20.5%) bunions. Functional impairment was mild [8 (5-14) median FIHOA]. Median serum CRP was 0.2 mg/dL (0.1-0.4) with 14 (20%) patients above reference value. Mean total KL score was 27.6 ± 13.6 with 21 (23%), 38 (41.7%), and 33 (36.2%) KL2, KL3, and KL4, respectively; 51 (54.8%) and 42 (45.2%) patients declared 9SY including 37.2% with a university degree. Individuals earning <3 MW had lower pinch (p < 0.004) and grip strength (p < 0.01), and higher FIHOA scores (p < 0.007), as compared to ≥3 MW earning group. Literacy or occupation did not impact outcome. SYSADOA were used by 13 (12.7%), 6 used oral and 3 topical anti-inflammatory drugs and 2 used 5 mg/d prednisone.

Conclusion: Clinical characteristics in our LIHOA cohort mirror those reported in affluent regions. Socioeconomic disparities influenced functional outcome in LIHOA cohort.

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社会条件对手部骨关节炎患者功能预后的影响：低收入手部骨关节炎（LIHOA）队列。

背景：手部骨关节炎（HOA）是一种高发疾病，可能受到社会不平等的影响。有关手部骨关节炎的研究很少来自欠发达地区。我们希望通过介绍低收入HOA队列（LIHOA）的临床特征来填补这一空白：2019年8月至2023年5月期间在巴西福塔莱萨就诊的119名符合ACR标准的HOA诊断患者的数据。评估包括疼痛（VAS，视觉模拟量表）、X 光（KL，Kellgren-Lawrence）、握力和夹力（KgF）、科钦手功能量表（CHFS）、FIHOA 和 SF-12 评分。社会数据包括每月的社会数据（结果：119 名患者中有 107 人被纳入调查：119 名患者中有 107 名被纳入。平均年龄为 61.9（±10.3）岁，其中女性 94 人（92%）。系统性动脉高血压（48%）、代谢综合征（42.8%）、血脂异常（28.4%）和肥胖（25%）是最常见的合并症。平均病程为 7.5 ± 7.1 年。休息和活动时的 VAS 中位值分别为 3（3-5）和 8（5-9）（P 4 IF 节点）。其他关节的 OA37（36.2%）人患有脊柱，28（29.4%）人患有膝关节，21（20.5%）人患有拇囊炎。功能障碍程度较轻[FIHOA 中位数为 8（5-14）]。血清 CRP 中位数为 0.2 mg/dL (0.1-0.4)，14 名（20%）患者高于参考值。KL 总分的平均值为 27.6 ± 13.6，其中 KL2、KL3 和 KL4 分别为 21（23%）、38（41.7%）和 33（36.2%）分；51（54.8%）和 42（45.2%）名患者申报了 9SY ，其中 37.2% 具有大学学历。个人收入结论：LIHOA队列中的临床特征与富裕地区的临床特征相同。社会经济差异影响了LIHOA队列的功能预后。

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来源期刊

Advances in Rheumatology Medicine-Rheumatology

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

53 weeks

期刊介绍： Formerly named Revista Brasileira de Reumatologia, the journal is celebrating its 60th year of publication. Advances in Rheumatology is an international, open access journal publishing pre-clinical, translational and clinical studies on all aspects of paediatric and adult rheumatic diseases, including degenerative, inflammatory and autoimmune conditions. The journal is the official publication of the Brazilian Society of Rheumatology and welcomes original research (including systematic reviews and meta-analyses), literature reviews, guidelines and letters arising from published material.