Journal of comorbidity最新文献

{"title":"The benefits and harms of therapeutic exercise on physical and psychosocial outcomes in people with multimorbidity: Protocol for a systematic review.","authors":"Alessio Bricca, Lasse K Harris, Madalina Saracutu, Susan M Smith, Carsten B Juhl, Søren T Skou","doi":"10.1177/2235042X20920458","DOIUrl":"10.1177/2235042X20920458","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to investigate the benefits and harms of therapeutic exercise in people with multimorbidity defined as the combination of two or more of the following conditions: knee and hip osteoarthritis, hypertension, diabetes type 2, depression, heart failure, ischaemic heart disease and chronic obstructive pulmonary disease, by performing a systematic review of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>This study will be performed according to the recommendations from the Cochrane Collaboration and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We will search for RCTs investigating the effect of therapeutic exercise in multimorbidity, as defined above, in MEDLINE, EMBASE, CENTRAL and CINAHL from 1990. Cochrane reviews on the effect of therapeutic exercise for each of the aforementioned conditions and references of the included studies will be checked for eligible studies and citation tracking will be performed in Web of Science. We will assess the risk of bias of the included studies using the Cochrane 'Risk of Bias Tool' 2.0 and the Grading of Recommendations Assessment, Development and Evaluation assessment for judging the overall quality of evidence. Meta-analyses will be performed, if possible, using a random-effects model as heterogeneity is expected due to differences in interventions and participant characteristics and outcome measures. Subgroup and meta-regression analyses will be performed to explore potential predictors of outcomes.</p><p><strong>Dissemination: </strong>The results of this systematic review will be published in a peer-review journal, presented at national and international conferences and made available to end users via infographics, podcasts, press releases and videos.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20920458"},"PeriodicalIF":0.0,"publicationDate":"2020-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20920458","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37952200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between midlife chronic conditions and medication use with anxiety and depression: A cross-sectional analysis of the PREVENT Dementia study.","authors":"Lucy E Stirland,&nbsp;Sarah Gregory,&nbsp;Tom C Russ,&nbsp;Craig W Ritchie,&nbsp;Graciela Muniz-Terrera","doi":"10.1177/2235042X20920443","DOIUrl":"https://doi.org/10.1177/2235042X20920443","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity including physical and mental illness is increasing in prevalence. We aimed to investigate the associations between physical conditions and medication use with anxiety and depression in midlife.</p><p><strong>Methods: </strong>We conducted an observational cross-sectional study of volunteers in the PREVENT Dementia study. Using logistic and linear regression, we investigated the association between increasing numbers of self-reported chronic physical conditions and medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest.</p><p><strong>Results: </strong>Of the 210 participants, 148 (71%) were women and 188 (90%) Caucasian. The mean age was 52 (standard deviation (SD) = 5.5) years. The mean number of physical conditions was 2.2 (SD = 1.9) and medications 1.7 (SD = 2.2). Each additional physical condition was associated with increased odds of self-reported depression (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.11-1.80; <i>p</i> = 0.004, adjusted for age and gender) and anxiety disorder (OR 1.70, 95% CI 1.30-2.37; <i>p <</i> 0.001). Increasing medication use was associated with self-reported depression (adjusted OR per additional medication 1.35, 95% CI 1.08-1.71; <i>p</i> = 0.008) but not anxiety disorder. For each additional condition, CES-D scores increased by 0.72 (95% CI 0.11-1.33; <i>p</i> = 0.020) and for each extra medication, by 0.88 (95% CI 0.32-1.44; <i>p</i> = 0.002). There was no significant association between increasing conditions and medications with STAI scores. In models accounting for antidepressant use, all associations were attenuated.</p><p><strong>Conclusions: </strong>Having more physical conditions is associated with anxiety and depression in midlife, and taking more medications is associated with depression but not anxiety.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20920443"},"PeriodicalIF":0.0,"publicationDate":"2020-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20920443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37952203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A feasibility study.","authors":"Maureen Markle-Reid, Ruta Valaitis, Amy Bartholomew, Kathryn Fisher, Rebecca Fleck, Jenny Ploeg, Jennifer Salerno","doi":"10.1177/2235042X19900451","DOIUrl":"10.1177/2235042X19900451","url":null,"abstract":"<p><strong>Background: </strong>Stroke is the leading cause of death and adult disability in Canada. Eighty percent of older adults (≥65 years) who have suffered a stroke will return to their homes, and 60% will require ongoing rehabilitation. The transition between hospital and home is often fragmented, leading to adverse health outcomes, hospital readmissions, and increased health-care costs. This study examined the feasibility of a 6-month integrated transitional care stroke intervention (TCSI), and explored its effects on health outcomes, patient and provider experience, and cost in 30 community-living older adults (≥55 years) with stroke and multimorbidity (≥2 chronic conditions) using outpatient stroke rehabilitation services.</p><p><strong>Methods: </strong>The TCSI is a 6-month intervention delivered by an interprofessional (IP) team (occupational therapist, physiotherapist, speech language pathologist, registered nurse, social worker). It involved care coordination, home visiting, and IP case conferences, supported by a web-based application. A qualitative descriptive approach was used to explore the feasibility of implementing the intervention. A prospective one-group pretest/posttest was used to evaluate the effects of the intervention on health outcomes and use and costs of health services, from baseline to 6 months.</p><p><strong>Results: </strong>Participants had an average of eight comorbid conditions. The intervention was feasible and acceptable to both older adults and providers. From baseline to 6 months, there was no statistically significant difference in health outcomes. However, there was a significant reduction in the total per person use and costs of health services.</p><p><strong>Conclusions: </strong>This study established the feasibility of conducting a larger randomized controlled trial of this intervention.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X19900451"},"PeriodicalIF":0.0,"publicationDate":"2020-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X19900451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37897180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urban-rural and socioeconomic status: Impact on multimorbidity prevalence in hospitalized patients.","authors":"Lynn Robertson, Dolapo Ayansina, Marjorie Johnston, Angharad Marks, Corri Black","doi":"10.1177/2235042X19893470","DOIUrl":"10.1177/2235042X19893470","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe multimorbidity prevalence in hospitalized adults, by urban-rural area of residence and socioeconomic status (SES).</p><p><strong>Methods: </strong>Linked hospital episode data were used. Adults (≥18 years) admitted to hospital as an inpatient during 2014 in Grampian, Scotland, were included. Conditions were identified from admissions during the 5 years prior to the first admission in 2014. Multimorbidity was defined as ≥2 conditions and measured using Tonelli et al. based on International Classification of Diseases-10 coding (preselected list of 30 conditions). We used proportions and 95% confidence intervals (CIs) to summarize the prevalence of multimorbidity by age group, sex, urban-rural category and deprivation. The association between multimorbidity and patient characteristics was assessed using the <i>χ</i> ² test.</p><p><strong>Results: </strong>Forty one thousand five hundred and forty-five patients were included (median age 62, 52.6% female). Overall, 27.4% (95% CI 27.0, 27.8) of patients were multimorbid. Multimorbidity prevalence was 28.8% (95% CI 28.1, 29.5) in large urban versus 22.0% (95% CI 20.9, 23.3) in remote rural areas and 28.7% (95% CI 27.2, 30.3) in the most deprived versus 26.0% (95% CI 25.2, 26.9) in the least deprived areas. This effect was consistent in all age groups, but not statistically significant in the age group 18-29 years. Multimorbidity increased with age but was similar for males and females.</p><p><strong>Conclusion: </strong>Given the scarcity of research into the effect of urban-rural area and SES on multimorbidity prevalence among hospitalized patients, these findings should inform future research into new models of care, including the consideration of urban-rural area and SES.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X19893470"},"PeriodicalIF":0.0,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/06/10.1177_2235042X19893470.PMC7171988.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37878406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the relationship between rheumatoid arthritis, multimorbidity and adverse health-related outcomes: A systematic review protocol.","authors":"Jordan Canning,&nbsp;Stefan Siebert,&nbsp;Bhautesh D Jani,&nbsp;Frances S Mair,&nbsp;Barbara I Nicholl","doi":"10.1177/2235042X20906657","DOIUrl":"https://doi.org/10.1177/2235042X20906657","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterised by articular inflammation and systemic complications. Multimorbidity (the presence of two or more long-term health conditions) is highly prevalent in people with RA but the effect of multimorbidity on mortality and other health-related outcomes is poorly understood.</p><p><strong>Objective: </strong>To determine what is known about the effect, if any, of multimorbidity on mortality and health-related outcomes in individuals with RA.</p><p><strong>Design: </strong>Systematic review of the literature. The following electronic medical databases will be searched: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, The Cochrane Library and Scopus. Included studies will be quality appraised using the Quality in Prognostic Studies tool developed by the Cochrane Prognosis Methods Group. A narrative synthesis of findings will be undertaken and meta-analyses considered, if appropriate. This protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 guidelines, ensuring the quality of the review.</p><p><strong>Conclusions: </strong>Understanding the influence of multimorbidity on mortality and other health-related outcomes in RA will provide an important basis of knowledge with the potential to improve future clinical management of RA. PROSPERO registration number: CRD42019137756.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20906657"},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20906657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37766245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity of HIV, hypertension, and diabetes and associated factors among people receiving antiretroviral therapy in Bahir Dar city, Ethiopia.","authors":"Zenebework Getahun,&nbsp;Muluken Azage,&nbsp;Taye Abuhay,&nbsp;Fantu Abebe","doi":"10.1177/2235042X19899319","DOIUrl":"https://doi.org/10.1177/2235042X19899319","url":null,"abstract":"<p><strong>Background: </strong>People living with human immunodeficiency virus (HIV) are facing an increased burden of noncommunicable diseases (NCDs) comorbidity. There is, however, paucity of information on the magnitude of HIV-NCDs comorbidity, its associated factors, and how the health system is responding to the double burden in Ethiopia.</p><p><strong>Objective: </strong>To determine the magnitude of comorbidity between HIV and hypertension or diabetes and associated factors among HIV-positive adults receiving antiretroviral therapy (ART) in Bahir Dar city, Ethiopia.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted among 560 randomly selected HIV-positive adults taking ART. Data were collected using a structured questionnaire and analyzed using SPSS version 23. Descriptive statistics were used to describe the data. A logistic regression model was fit to identify associated factors with comorbidity of HIV and NCDs.</p><p><strong>Results: </strong>The magnitude of comorbidity was 19.6% (95% confidence interval (CI): 16.0-23.0). Being older (55 and above years) adjusted odds ratio (AOR: 8.5; 95% CI: 3.2-15.1), taking second-line ART regimen containing tenofovir (AOR: 2.7; 95% CI: 1.3-5.6), and increased body mass index (BMI) ≥25 (AOR: 2.7; 95% CI: 1.2-6.5) were the factors associated with comorbidity. Participants reported that they were not managed in an integrated and coordinated manner.</p><p><strong>Conclusions: </strong>The magnitude of comorbidity among adults was high in the study area. Being older, second-line ART regimen and high BMI ≥25 increased the odds of having NCDs among HIV-positive adults. Targeted screening for the incidences of NCDs, addressing modifiable risk factors, and providing integrated care would help to improve the quality of life comorbid patients.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X19899319"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X19899319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37766243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health behaviour, social support, socio-economic status and the 5-year progression of multimorbidity: Results from the MultiCare Cohort Study.","authors":"Ingmar Schäfer,&nbsp;Heike Hansen,&nbsp;Hanna Kaduszkiewicz,&nbsp;Horst Bickel,&nbsp;Angela Fuchs,&nbsp;Jochen Gensichen,&nbsp;Wolfgang Maier,&nbsp;Steffi G Riedel-Heller,&nbsp;Hans-Helmut König,&nbsp;Anne Dahlhaus,&nbsp;Gerhard Schön,&nbsp;Siegfried Weyerer,&nbsp;Birgitt Wiese,&nbsp;Hendrik van den Bussche,&nbsp;Martin Scherer","doi":"10.1177/2235042X19883560","DOIUrl":"https://doi.org/10.1177/2235042X19883560","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity in elderly patients is a major challenge for physicians, because of a high prevalence of and associations with many adverse outcomes. However, the mechanisms of progressing multimorbidity are not well-understood. The aim of our study was to determine if the progression of multimorbidity is influenced by health behaviour and social support and to analyse if the patients' socio-economic status had an effect on these prognostic factors.</p><p><strong>Methods: </strong>The study was designed as prospective cohort study based on interviews of 158 GPs and 3189 patients randomly selected from GP records (response rate: 46.2%). Patients were aged 65-85 years at recruitment and observed in four waves of data collection (dropout rate: 41.5%). Statistical analyses of the 'hot deck' imputed data included multilevel mixed-effects linear regression allowing for random effects at the study centre and GP practice within study centre level.</p><p><strong>Results: </strong>Regarding cardiovascular and metabolic diseases, multimorbidity progressed more rapidly in patients who reported less physical activity (<i>ß</i> = -0.28; 95% confidence interval = -0.35 to -0.20), had more tobacco-related pack years (0.15; 0.07-0.22) and consumed less alcohol (-0.21; -0.31 to -0.12) at baseline. Multimorbidity related to psychiatric and pain-related disorders progressed more rapidly if the patients had less perceived social support (-0.31; -0.55 to -0.07) and reported less physical activity (-0.08; -0.15 to -0.02) at baseline. Education and income only slightly modified the effects of these variables.</p><p><strong>Conclusion: </strong>Depending on the multimorbidity cluster, different strategies should be used for slowing down the progression of multimorbidity. Changing lifestyle and increasing social support are beneficial for the entire group of elderly multimorbid patients - regardless of their socio-economic status.</p><p><strong>Registration: </strong>ISRCTN89818205.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"9 ","pages":"2235042X19883560"},"PeriodicalIF":0.0,"publicationDate":"2019-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X19883560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39638519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study.","authors":"J Jaime Miranda,&nbsp;Antonio Bernabe-Ortiz,&nbsp;Robert H Gilman,&nbsp;Liam Smeeth,&nbsp;German Malaga,&nbsp;Robert A Wise,&nbsp;William Checkley","doi":"10.1177/2235042X19875297","DOIUrl":"https://doi.org/10.1177/2235042X19875297","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the prevalence and clustering of multimorbidity in four diverse geographical settings in Peru.</p><p><strong>Methods: </strong>Multimorbidity, defined as having ≥2 chronic conditions, was studied in adults aged ≥35 years in four diverse settings in Peru: Lima, Tumbes, and urban and rural Puno. Six of these conditions (alcohol disorder, asthma, chronic obstructive pulmonary disease, depression, diabetes, and hypertension) were cataloged as objectively ascertained chronic conditions and paired in dyads to explore clusters of multimorbidity.</p><p><strong>Results: </strong>We analyzed data from 2890 adults, mean age 55.2 years, 49% males. Overall, 19.1% of participants had multimorbidity, ranging from 14.7% in semi-urban Tumbes to 22.8% in Lima. The dyads with the highest coexistence (approximately 20%) were observed in hypertension and diabetes in Tumbes, whereas the dyads with lowest coexistence (approximately 1%) were those involving asthma in all study sites. In terms of clusters, Tumbes showed a predominance of hypertension and diabetes, urban and rural Puno a predominance of depression and alcohol disorders, and Lima a higher degree of coexistence of all of the six conditions than in the other clusters.</p><p><strong>Conclusion: </strong>Multimorbidity is common and the pattern of clusters is highly heterogeneous. The conditions to prioritize will vary in each setting.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"9 ","pages":"2235042X19875297"},"PeriodicalIF":0.0,"publicationDate":"2019-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X19875297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39174795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies.","authors":"Hai Nguyen,&nbsp;Gergana Manolova,&nbsp;Christina Daskalopoulou,&nbsp;Silia Vitoratou,&nbsp;Martin Prince,&nbsp;A Matthew Prina","doi":"10.1177/2235042X19870934","DOIUrl":"https://doi.org/10.1177/2235042X19870934","url":null,"abstract":"<p><strong>Background: </strong>With ageing world populations, multimorbidity (presence of two or more chronic diseases in the same individual) becomes a major concern in public health. Although multimorbidity is associated with age, its prevalence varies. This systematic review aimed to summarise and meta-analyse the prevalence of multimorbidity in high, low- and middle-income countries (HICs and LMICs).</p><p><strong>Methods: </strong>Studies were identified by searching electronic databases (Medline, Embase, PsycINFO, Global Health, Web of Science and Cochrane Library). The term 'multimorbidity' and its various spellings were used, alongside 'prevalence' or 'epidemiology'. Quality assessment employed the Newcastle-Ottawa scale. Overall and stratified analyses according to multimorbidity operational definitions, HICs/LMICs status, gender and age were performed. A random-effects model for meta-analysis was used.</p><p><strong>Results: </strong>Seventy community-based studies (conducted in 18 HICs and 31 LMICs) were included in the final sample. Sample sizes ranged from 264 to 162,464. The overall pooled prevalence of multimorbidity was 33.1% (95% confidence interval (CI): 30.0-36.3%). There was a considerable difference in the pooled estimates between HICs and LMICs, with prevalence being 37.9% (95% CI: 32.5-43.4%) and 29.7% (26.4-33.0%), respectively. Heterogeneity across studies was high for both overall and stratified analyses (<i>I</i> ² > 99%). A sensitivity analysis showed that none of the reviewed studies skewed the overall pooled estimates.</p><p><strong>Conclusion: </strong>A large proportion of the global population, especially those aged 65+, is affected by multimorbidity. To allow accurate estimations of disease burden, and effective disease management and resources distribution, a standardised operationalisation of multimorbidity is needed.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"9 ","pages":"2235042X19870934"},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X19870934","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity and mortality in patients with rheumatoid arthritis compared with an age- and sex-matched control population: A nationwide register study.","authors":"Katrine Løppenthin,&nbsp;Bente Appel Esbensen,&nbsp;Mikkel Østergaard,&nbsp;Rikke Ibsen,&nbsp;Jakob Kjellberg,&nbsp;Poul Jennum","doi":"10.1177/2235042X19853484","DOIUrl":"https://doi.org/10.1177/2235042X19853484","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the prevalence of morbidity and mortality in patients with seropositive rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Data were obtained from national population-based registries in the period 1998-2009. Prior to the seropositive RA diagnosis (International Classification of Disorders 10th revision M05), we identified a total of 21,558 patients and 87,384 age- and sex-matched control subjects. Odds for morbidity were calculated before and after the RA diagnosis. We estimated the overall survival based on the Kaplan-Meier method.</p><p><strong>Results: </strong>Patients with RA had statistically significantly higher odds for a number of co-morbidities prior to the onset of RA including diseases of the musculoskeletal system (odds ratio (OR) 3.10, 95% confidence interval (CI) 3.00-3.21), diseases involving the immune system (OR 1.45, 95% CI 1.29-1.64), endocrine diseases (OR 1.09, 95% CI 1.01-1.17), diseases of the circulatory system (OR 1.08, 95% CI 1.03-1.14) and diseases of the respiratory system (OR 1.30, 95% CI 1.22-1.38), compared with age- and sex-matched control subjects. After the RA diagnosis, the same trend was seen with higher odds for the same co-morbidities. We found a 5-year survival of 80% (95% CI 78-81%) for patients with RA, while for control subjects it was 88% (95% CI 88-89%).</p><p><strong>Conclusion: </strong>Compared with age- and sex-matched controls, patients with seropositive RA have higher odds for several co-morbidities prior to and, particularly, after the diagnosis of RA. Furthermore, patients with RA have a lower overall survival compared with age- and sex-matched controls.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"9 ","pages":"2235042X19853484"},"PeriodicalIF":0.0,"publicationDate":"2019-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X19853484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37338937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}