目的:比较有和没有风湿性和肌肉骨骼疾病(RMDs)的人之间的多发病模式,并描述这些模式如何随年龄和性别而变化。2010年至2019年。
方法:在395个威尔士一般惯例(GP)中注册了103426名RMD和290万比较者。2010年1月至2019年12月在临床实践研究威尔士实践中注册的每位年龄为0-100岁的RMD患者与多达五名没有RMD的比较者相匹配。根据年龄,性别和GP代码。
方法:患有RMD和按年龄分类的比较者的29种Elixhauser定义的合并症的患病率,性别和GP实践。拟合条件逻辑回归模型以计算差异(OR,95%CI)与队列之间的合并症相关。
结果:最普遍的合并症是心血管危险因素,高血压和糖尿病。诊断为RMD与许多疾病(包括缺乏性贫血)的几率显着升高(OR1.39,95%CI(1.32至1.46)),甲状腺功能减退(OR1.34,95%CI(1.19至1.50)),肺循环障碍(OR1.39,95%CI1.12~1.73)糖尿病(OR1.17,95%CI(1.11~1.23))和液体和电解质紊乱(OR1.27,95%CI(1.17~1.38)).与非RMD组相比,RMD具有更高比例的多浊度(除RMD外还有两种或更多种条件)(81%和73%,分别在2019年),25岁以上女性和50岁以上男性的平均合并症数量高于非RMDs组。
结论:患有RMD的人群多发病的可能性是普通人群的1.5倍,为有针对性的干预研究提供了高危人群。患有RMD的人经历了更多的共存健康状况,往往表现在早期。这种现象在妇女中尤为明显。此外,RMD患者的合并症报告不足。
OBJECTIVE: To compare the patterns of multimorbidity between people with and without rheumatic and musculoskeletal diseases (RMDs) and to describe how these patterns change by age and sex over time, between 2010 and 2019.
METHODS: 103 426 people with RMDs and 2.9 million comparators registered in 395 Wales general practices (GPs). Each patient with an RMD aged 0-100 years between January 2010 and December 2019 registered in Clinical Practice Research Welsh practices was matched with up to five comparators without an RMD, based on age, gender and GP code.
METHODS: The prevalence of 29 Elixhauser-defined comorbidities in people with RMDs and comparators categorised by age, gender and GP practices. Conditional logistic regression models were fitted to calculate differences (OR, 95% CI) in associations with comorbidities between cohorts.
RESULTS: The most prevalent comorbidities were cardiovascular risk factors, hypertension and diabetes. Having an RMD diagnosis was associated with a significantly higher odds for many conditions including deficiency anaemia (OR 1.39, 95% CI (1.32 to 1.46)), hypothyroidism (OR 1.34, 95% CI (1.19 to 1.50)), pulmonary circulation disorders (OR 1.39, 95% CI 1.12 to 1.73) diabetes (OR 1.17, 95% CI (1.11 to 1.23)) and fluid and electrolyte disorders (OR 1.27, 95% CI (1.17 to 1.38)). RMDs have a higher proportion of multimorbidity (two or more conditions in addition to the RMD) compared with non-RMD group (81% and 73%, respectively in 2019) and the mean number of comorbidities was higher in women from the age of 25 and 50 in men than in non-RMDs group.
CONCLUSIONS: People with RMDs are approximately 1.5 times as likely to have multimorbidity as the general population and provide a high-risk group for targeted intervention studies. The individuals with RMDs experience a greater load of coexisting health conditions, which tend to manifest at earlier ages. This phenomenon is particularly pronounced among women. Additionally, there is an under-reporting of comorbidities in individuals with RMDs.