Swain, S, Coupland, C, Strauss, V, Mallen, C, Kuo, CF, Sarmanova, A, Bierma-Zeinstra, SMA, Englund, M, Prieto-Alhambra, D, Doherty, M and Zhang, W (2022) Clustering of comorbidities and associated outcomes in people with osteoarthritis - a UK Clinical Practice Research Datalink study. Osteoarthritis and Cartilage. ISSN 1522-9653

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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=221807) between 1997-2017 and age (+2 years), gender, and practice matched controls (no osteoarthritis, n=221807) 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.

Item Type: Article
Additional Information: The final version of this article and all relevant information related to it, including copyrights, can be found on the publisher website at; https://www.sciencedirect.com/science/article/pii/S1063458422000139
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 15 Mar 2022 16:17
Last Modified: 15 Mar 2022 16:17
URI: https://eprints.keele.ac.uk/id/eprint/10621

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