Lifetime risk of knee and hip replacement following a diagnosis of RA : findings from a cohort of 13 961 patients from England

Objective: To estimate the lifetime risk of knee and hip replacement following a diagnosis of RA. Methods: The analysis was undertaken using routinely collected data from the English NHS. Diagnosis of RA was identified using primary care records, with knee and hip replacement observed in linked hosp...

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Detalles Bibliográficos
Autores: Burn, Edward|||0000-0002-9286-1128, Edwards, Christopher J., Murray, David W., Silman, Alan, Cooper, Cyrus|||0000-0003-3510-0709, Arden, N. K|||0000-0002-3452-3382, Pinedo-Villanueva, Rafael|||0000-0002-4723-5128, Prieto-Alhambra, Daniel|||0000-0002-3950-6346
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:223655
Acceso en línea:https://ddd.uab.cat/record/223655
https://dx.doi.org/urn:doi:10.1093/rheumatology/kez143
Access Level:acceso abierto
Palabra clave:Rheumatoid arthritis
Surgery
Epidemiology
Knee
Hip
Descripción
Sumario:Objective: To estimate the lifetime risk of knee and hip replacement following a diagnosis of RA. Methods: The analysis was undertaken using routinely collected data from the English NHS. Diagnosis of RA was identified using primary care records, with knee and hip replacement observed in linked hospital records. Parametric survival models were fitted for up to 15 years of follow-up, with age, sex, Charlson comorbidity score, socioeconomic status, BMI and smoking status included as explanatory variables. A decision model was used to combine and extrapolate survival models to estimate lifetime risk. Results: The number of individuals with a diagnosis of RA and included in the study was 13 961. Lifetime risk of knee replacement and hip replacement was estimated to be 22% (95% CI: 16, 29%) and 17% (95% CI: 11, 26%) following a diagnosis of RA for the average patient profile (non-smoking women aged 64 with no other comorbidities, BMI of 27 and in the top socioeconomic quintile). Risks were higher for younger patients. Conclusion: The lifetime risk of knee and hip replacement for individuals with a diagnosis of RA is approximately double that of the general population. These findings allow for a better understanding of long-term prognosis and healthcare resource use, and highlight the importance of timely diagnosis and effective treatment.