Classification of long-term condition patterns in rheumatoid arthritis and associations with adverse health events: a UK Biobank cohort study.
| Autor: | McLoone, Philip, Jani, Bhautesh D., Siebert, Stefan, Morton, Fraser R., Canning, Jordan, Macdonald, Sara, Mair, Frances S., Nicholl, Barbara I. |
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| Předmět: |
STRUCTURAL equation modeling
HYPERTENSION OBESITY THYROID diseases CONFIDENCE intervals ASTHMA CHRONIC diseases MIGRAINE MAJOR adverse cardiovascular events REGRESSION analysis DIABETES TREATMENT effectiveness PHYSICAL activity RHEUMATOID arthritis DISEASE duration DESCRIPTIVE statistics ALCOHOL drinking HOSPITAL care OBSTRUCTIVE lung diseases RESEARCH funding DATA analysis software SMOKING TUMORS COMORBIDITY SECONDARY analysis PROPORTIONAL hazards models INDIGESTION HEART failure |
| Zdroj: | Journal of Multimorbidity & Comorbidity; Jan-Dec2023, Vol. 13, p1-12, 12p |
| Abstrakt: | Purpose: We aimed to classify individuals with RA and =2 additional long-term conditions (LTCs) and describe the association between different LTC classes, number of LTCs and adverse health outcomes. Methods: We used UK Biobank participants who reported RA (n=5,625) and employed latent class analysis (LCA) to create classes of LTC combinations for those with =2 additional LTCs. Cox-proportional hazard and negative binomial regression were used to compare the risk of all-cause mortality, major adverse cardiac events (MACE), and number of emergency hospitalisations over an 11-year follow-up across the different LTC classes and in those with RA plus one additional LTC. Persons with RA without LTCs were the reference group. Analyses were adjusted for demographic characteristics, smoking, BMI, alcohol consumption and physical activity. Results: A total of 2,566 (46%) participants reported =2 LTCs in addition to RA. This involved 1,138 distinct LTC combinations of which 86% were reported by =2 individuals. LCA identified 5 morbidity-classes. The distinctive condition in the class with the highest mortality was cancer (class 5; HR 2.66 95%CI (1.91-3.70)). The highest MACE (HR 2.95 95%CI (2.11-4.14)) and emergency hospitalisations (rate ratio 3.01 (2.56-3.54)) were observed in class 3 which comprised asthma, COPD & CHD. There was an increase in mortality, MACE and emergency hospital admissions within each class as the number of LTCs increased. Conclusions: The risk of adverse health outcomes in RA varied with different patterns of multimorbidity. The pattern of multimorbidity should be considered in risk assessment and formulating management plans in patients with RA. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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