OBJECTIVE:To determine the influence of comorbidity on physical function in osteoarthritis (OA) consulters aged 50 years and over in family practice. METHODS:The study design linked morbidity consultations during an 18-month period to self-reported physical function status measured at the end of the period. Clinical comorbidity was compared between consulters with (n = 1026) and without (n = 8160) OA. Comorbidity was defined by morbidity counts (1-2 low, 3-4 medium,> 5 high) and by a measure of severity of individual morbidities based on chronicity. Associations between comorbidity and physical function were assessed using unconditional logistic regression, adjusting for age, sex, and socioeconomic deprivation. RESULTS:Of the 1026 OA consulters, 38 (3.7%) had an OA consultation only, 260 (25.3%) had low, 288 (28.1%) medium, and 440 (42.9%) high morbidity counts. Higher OA comorbid counts were associated with poorer physical function, after adjusting for age, sex, and socioeconomic deprivation. Associations between OA comorbidity severity and poor physical function showed estimates that were in excess of simply multiplying the individual effects of OA and comorbidity severity separately. Comorbidity, however, did not explain all of the association between OA and poor physical function. CONCLUSION:Comorbidity increases the likelihood of poor physical function in patients with OA in population-based family practice. The combined influence is greater than would be expected from the influence of either OA or the comorbid conditions alone. Treating comorbidity in patients with OA is likely to be crucial in preventing or reducing the related physical decline.

译文

目的:确定合并症对50岁及以上的家庭实践中骨关节炎(OA)咨询员身体功能的影响。
方法:本研究设计将18个月期间的发病率咨询与该阶段结束时测得的自我报告的身体功能状态联系起来。比较了有(n = 1026)和没有(n = 8160)OA的顾问之间的临床合并症。合并症的定义是发病率计数(1-2低,3-4中,> 5高)和根据慢性病对个体发病严重程度的度量。使用无条件逻辑回归评估合并症和身体机能之间的关联,并根据年龄,性别和社会经济剥夺情况进行调整。
结果:在1026名OA顾问中,仅进行OA咨询的有38名(3.7%),低(260)(25.3%)低,288(28.1%)中,440(42.9%)高发病率。在调整了年龄,性别和社会经济剥夺之后,较高的OA合并症计数与较差的身体机能相关。 OA合并症严重程度与身体机能不良之间的关联表明,估计值超过了简单地将OA和合并症严重程度的单独影响相乘的程度。然而,合并症并不能解释OA与身体机能不良之间的所有关联。
结论:合并症增加了以人群为基础的家庭实践中OA患者身体机能不良的可能性。合并的影响大于从OA或单独的合并症的影响所预期的影响。在OA患者中治疗合并症可能对于预防或减少相关的体力下降至关重要。

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