Abstract：
OBJECTIVE: To identify multimorbidity trajectories over 20 years among incident osteoarthritis (OA) individuals and OA-free matched references.
METHODS: Cohort study using prospectively collected healthcare data from the Skåne region, Sweden (~1.4 million residents). We extracted diagnoses for OA and 67 common chronic conditions. We included individuals aged 40+ years on 31 December 2007, with incident OA between 2008 and 2009. We selected references without OA, matched on birth year, sex, and year of death or moving outside the region. We employed group-based trajectory modelling to capture morbidity count trajectories from 1998 to 2019. Individuals without any comorbidity were included as a reference group but were not included in the model.
RESULTS: We identified 9846 OA cases (mean age: 65.9 (SD 11.7), female: 58%) and 9846 matched references. Among both cases and references, 1296 individuals did not develop chronic conditions (no-chronic-condition class). We identified four classes. At the study outset, all classes exhibited a low average number of chronic conditions (≤1). Class 1 had the slowest progression towards multimorbidity, which increased progressively in each class. Class 1 had the lowest count of chronic conditions at the end of the follow-up (mean: 2.9 (SD 1.7)), while class 4 had the highest (9.6 (2.6)). The presence of OA was associated with a 1.29 (1.12, 1.48) adjusted relative risk of belonging to class 1 up to 2.45 (2.12, 2.83) for class 4.
CONCLUSIONS: Our findings suggest that individuals with OA face an almost threefold higher risk of developing severe multimorbidity.
METHODS: Cohort study using prospectively collected healthcare data from the Skåne region, Sweden (~1.4 million residents). We extracted diagnoses for OA and 67 common chronic conditions. We included individuals aged 40+ years on 31 December 2007, with incident OA between 2008 and 2009. We selected references without OA, matched on birth year, sex, and year of death or moving outside the region. We employed group-based trajectory modelling to capture morbidity count trajectories from 1998 to 2019. Individuals without any comorbidity were included as a reference group but were not included in the model.
RESULTS: We identified 9846 OA cases (mean age: 65.9 (SD 11.7), female: 58%) and 9846 matched references. Among both cases and references, 1296 individuals did not develop chronic conditions (no-chronic-condition class). We identified four classes. At the study outset, all classes exhibited a low average number of chronic conditions (≤1). Class 1 had the slowest progression towards multimorbidity, which increased progressively in each class. Class 1 had the lowest count of chronic conditions at the end of the follow-up (mean: 2.9 (SD 1.7)), while class 4 had the highest (9.6 (2.6)). The presence of OA was associated with a 1.29 (1.12, 1.48) adjusted relative risk of belonging to class 1 up to 2.45 (2.12, 2.83) for class 4.
CONCLUSIONS: Our findings suggest that individuals with OA face an almost threefold higher risk of developing severe multimorbidity.
摘要：
目的：在20年以上的骨关节炎（OA）个体和无OA匹配的参考人群中确定多发病轨迹。
方法：使用前瞻性收集的来自Skáne地区的医疗保健数据进行队列研究，瑞典（约140万居民）。我们提取了OA和67种常见慢性病的诊断。我们纳入了2007年12月31日40岁以上的个人，在2008年至2009年期间发生OA事件。我们选择了没有OA的参考，匹配出生年份，性别,以及死亡或迁出该地区的年份。我们采用基于组的轨迹建模来捕获1998年至2019年的发病率计数轨迹。没有任何合并症的个体被包括作为参照组,但不包括在模型中。
结果：我们确定了9846例OA病例（平均年龄：65.9（SD11.7），女性：58%）和9846个匹配的参考。在案例和参考文献中，1296名个体未发展为慢性病症(非慢性病症类别)。我们确定了四个班级。在研究开始时，所有类别的慢性疾病平均数量较低(≤1).1级向多发病进展最慢，在每个班级中逐渐增加。在随访结束时，第1类的慢性疾病计数最低（平均值：2.9（SD1.7）），而4班最高（9.6（2.6））。OA的存在与1.29（1.12，1.48）调整后的属于第1类的相对风险相关，第4类的相对风险高达2.45（2.12，2.83）。
结论：我们的研究结果表明，患有OA的个体发生严重多重性疾病的风险几乎高出三倍。
方法：使用前瞻性收集的来自Skáne地区的医疗保健数据进行队列研究，瑞典（约140万居民）。我们提取了OA和67种常见慢性病的诊断。我们纳入了2007年12月31日40岁以上的个人，在2008年至2009年期间发生OA事件。我们选择了没有OA的参考，匹配出生年份，性别,以及死亡或迁出该地区的年份。我们采用基于组的轨迹建模来捕获1998年至2019年的发病率计数轨迹。没有任何合并症的个体被包括作为参照组,但不包括在模型中。
结果：我们确定了9846例OA病例（平均年龄：65.9（SD11.7），女性：58%）和9846个匹配的参考。在案例和参考文献中，1296名个体未发展为慢性病症(非慢性病症类别)。我们确定了四个班级。在研究开始时，所有类别的慢性疾病平均数量较低(≤1).1级向多发病进展最慢，在每个班级中逐渐增加。在随访结束时，第1类的慢性疾病计数最低（平均值：2.9（SD1.7）），而4班最高（9.6（2.6））。OA的存在与1.29（1.12，1.48）调整后的属于第1类的相对风险相关，第4类的相对风险高达2.45（2.12，2.83）。
结论：我们的研究结果表明，患有OA的个体发生严重多重性疾病的风险几乎高出三倍。
