Hospital-Treated Infections and 15-year Incidence of Musculoskeletal Disorders: A Large Population-Based Cohort Study.

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI:10.2147/CLEP.S494047

Yaqing Gao, Dylan McGagh, Lei Ding, Shenda Hong, Zhengxiao Ouyang, Jie Wei, Chao Zeng, Guanghua Lei, Junqing Xie

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引用次数: 0

Abstract

Background: Basic science evidence reveals interactions between the immune and bone systems. However, population studies linking infectious diseases and musculoskeletal (MSK) disorders are limited and inconsistent. We aimed to examine the risk of six main MSK disorders (osteoarthritis, rheumatoid arthritis, osteoporosis, gout, low back pain, and neck pain) following hospital-treated infections in a large cohort with long follow-up periods.

Methods: We analysed data from 502,409 UK Biobank participants. Participants free of specific MSK disorders at baseline were included in each analysis. Hospital-treated infections before baseline were identified using national inpatient data, while incident MSK outcomes were ascertained from inpatient records, primary care, and death registers. Participants with prior infections were propensity score matched (1:5) with those without. Hazard ratios (HRs) and absolute rate differences (ARDs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. To assess potential reverse causality due to delayed diagnosis of preexisting illness, analyses were repeated excluding MSK disorder cases that occurred within the first 5 and 10 years post-baseline.

Results: A hospital-treated infection was associated with increased risks of all six MSK disorders, with particularly strong associations for osteoporosis (HR, 1.55 [1.48-1.63]; ARD, 1.48 [95% CI 1.29-1.68] per 1000 person-years) and rheumatoid arthritis (HR, 1.53 [1.41-1.65]; ARD, 0.58 [0.46-0.71] per 1000 person-years), while other disorders showed HRs of 1.28-1.32. Bacterial and viral infections showed similar associations, with MSK infections (generally stronger risk) and other locations both linked to increased risks. Associations remained significant even for incident cases that occurred more than 10 years post-baseline.

Conclusion: Hospital-treated infections are associated with long-term MSK disorder risks, regardless of pathogen type or disorder nature (inflammatory or degenerative). Long-term monitoring and care for MSK health in patients with prior hospital-treated infections are recommended.

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医院治疗感染和15年肌肉骨骼疾病发病率：一项基于人群的大型队列研究

背景：基础科学证据揭示了免疫系统和骨骼系统之间的相互作用。然而，将传染病和肌肉骨骼疾病（MSK）联系起来的人口研究是有限和不一致的。我们的目的是在一个长期随访的大型队列中，研究医院治疗感染后六种主要MSK疾病（骨关节炎、类风湿性关节炎、骨质疏松症、痛风、腰痛和颈部疼痛）的风险。方法：我们分析了502409名英国生物银行参与者的数据。在基线时无特定MSK疾病的参与者被纳入每个分析。基线前的医院治疗感染是通过国家住院患者数据确定的，而MSK事件的结果是通过住院记录、初级保健和死亡登记确定的。先前感染的参与者倾向得分匹配（1:5）与那些没有。采用Cox比例风险模型计算95%置信区间的风险比（hr）和绝对率差（ARDs）。为了评估由于先前存在疾病的延迟诊断而导致的潜在反向因果关系，重复分析，排除基线后前5年和10年内发生的MSK疾病病例。结果：医院治疗的感染与所有六种MSK疾病的风险增加相关，与骨质疏松症的相关性特别强(HR, 1.55 [1.48-1.63]；ARD, 1.48 [95% CI 1.29-1.68] / 1000人-年)和类风湿关节炎(HR, 1.53 [1.41-1.65]；ARD为0.58[0.46-0.71]/ 1000人年)，而其他疾病的hr为1.28-1.32。细菌和病毒感染表现出类似的关联，MSK感染（通常风险更大）和其他地方的感染都与风险增加有关。即使在基线后10年以上发生的事件病例中，相关性仍然显著。结论：医院治疗感染与长期MSK疾病风险相关，无论病原体类型或疾病性质（炎症性或退行性）如何。建议对既往住院治疗感染患者的MSK健康进行长期监测和护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.