Presence of comorbidities and prognosis of clinical symptoms in knee and/or hip osteoarthritis: A systematic review and meta-analysis

被引:120
作者
Calders, Patrick [1 ]
Van Ginckel, Ans [2 ,3 ]
机构
[1] Univ Ghent, Fac Med & Hlth Sci, Dept Rehabil Sci & Physiotherapy, Ghent, Belgium
[2] Ghent Univ Hosp Campus, Fac Med & Hlth Sci, Dept Rehabil Sci & Physiotherapy, Bldg 3B3,Room 007,Pintelaan 185, BE-9000 Ghent, Belgium
[3] EU Horizon 2020 Program, Brussels, Belgium
基金
欧盟地平线“2020”;
关键词
Pain; Physical function; Comorbidity; Prognosis; LOW-BACK-PAIN; DEPRESSIVE SYMPTOMS; FUNCTIONAL LIMITATIONS; REPORTED OUTCOMES; HEALTH-STATUS; OLDER-ADULTS; JOINT-PAIN; TRAJECTORIES; DISABILITY; IMPACT;
D O I
10.1016/j.semarthrit.2017.10.016
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: (i) To determine the association between the presence of comorbidities and severity of pain and physical dysfunction in people with knee and/or hip osteoarthritis; (ii) to explore associations between specific comorbidities (cardiac disease and/or hypertension, diabetes, depression, and back pain) and symptom severity. Methods: Studies were identified through systematic searches in four electronic databases and grey literature, and, subsequently, methodologically appraised. Eligible citations entailed cross-sectional or longitudinal studies as well as randomised controlled trials providing data of a direct association between comorbidity presence and the severity of self-reported and/or performance-based symptoms of pain and/or physical functioning, in people with knee and/or hip osteoarthritis. We performed random effects meta-analysis if at least two citations of low-to-moderate risk of bias were available. The quality of the body of evidence was determined using Cochrane-recommended methods. Results: Of all eligible citations (n = 26), 17 studies were entered in meta-analysis. Moderate quality evidence revealed an association between having >= 1 general comorbidity and worsening of pain (regression coefficient (95% confidence interval (CI)): 0.18 (95% CI: 0.14,0.22)) and/or performance-based physical functioning (0.20 (95% CI: 0.10,0.29)). The presence of cardiac disease and/or hypertension (self-reported: 0.08 (95% CI: 0.01,0.16); performance-based: 0.11 (95% CI: 0.02,0.20)), or back pain (self-reported: 0.12 (95% CI: 0.04,0.20)) predicted deteriorated physical functioning. Co-existing diabetes was associated with worse pain (0.10 (95% CI: 0.02,0.17)). Other findings were non-significant and/or the evidence of poor quality. Conclusions: Greater comorbidity burden contributes to worse pain and performance-based physical function in people with knee and/or hip osteoarthritis. Suffering comorbid cardiac disease including hypertension, back pain or diabetes may have differential effects on symptom severity. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:805 / 813
页数:9
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