R J Cleveland1, C Alvarez2, A E Nelson3, T A Schwartz4, J B Renner5, J M Jordan6, L F Callahan7. 1. Thurston Arthritis Research Center, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA. Electronic address: becki@unc.edu. 2. Thurston Arthritis Research Center, School of Medicine, University of North Carolina, Chapel Hill, NC, USA. Electronic address: alvarec@live.unc.edu. 3. Thurston Arthritis Research Center, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA. Electronic address: amanda_nelson@med.unc.edu. 4. Thurston Arthritis Research Center, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA; School of Nursing, University of North Carolina, Chapel Hill, NC, USA. Electronic address: tschwart@email.unc.edu. 5. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA. Electronic address: jordan_renner@med.unc.edu. 6. Thurston Arthritis Research Center, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA. Electronic address: joanne_jordan@med.unc.edu. 7. Thurston Arthritis Research Center, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA; Departments of Orthopaedics and Social Medicine, University of North Carolina, Chapel Hill, NC, USA. Electronic address: leigh_callahan@med.unc.edu.
Abstract
OBJECTIVE: To investigate the impact of hip osteoarthritis (OA) and/or hip symptoms on excess mortality. DESIGN: We analyzed data from 3,919 individuals in a community-based prospective cohort of African Americans and Caucasians age ≥45 years. Women ≥50 years of age and all men underwent supine anteroposterior pelvic radiography at baseline, with the participant's feet in 15 degrees of internal rotation. Hip radiographic (rOA) was defined as a Kellgren-Lawrence grade of ≥2 in at least one hip. Participants completed questionnaires at baseline to determine presence of hip symptoms and covariate status. Participants with symptomatic hip rOA (SxOA) are a subset of individuals with hip rOA and symptoms in the same hip. Multiple imputation was used to impute missing values of covariates. Mortality was determined through 2015 and follow-up time was calculated from baseline assessment until death or censoring which took place when a participant was lost to follow-up or reached the end of study period. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). We carried out additional analyses stratified by sex, race, age and obesity. RESULTS: Mean follow-up time was 14.2 years during which 1762 deaths occurred. There were 29.9% participants in our population with hip rOA at baseline. Compared to those with neither hip rOA nor hip symptoms, we observed an increased risk of all-cause mortality in participants with hip symptoms alone (HR = 1.28, 95% CI = 1.13-1.46), but no association for hip rOA either with or without symptoms. In stratified analyses we observed increased associations for hip symptoms alone and hip sxOA in those <65 years (43% and 39% increase, respectively) and in Caucasians (34% and 21% increase, respectively). CONCLUSIONS: Individuals who had hip symptoms without hip rOA had an increased risk of mortality. These effects were particularly strong for those who were <65 years of age and Caucasians. Effective interventions to identify those with hip pain in order to lessen it could reduce premature mortality.
OBJECTIVE: To investigate the impact of hip osteoarthritis (OA) and/or hip symptoms on excess mortality. DESIGN: We analyzed data from 3,919 individuals in a community-based prospective cohort of African Americans and Caucasians age ≥45 years. Women ≥50 years of age and all men underwent supine anteroposterior pelvic radiography at baseline, with the participant's feet in 15 degrees of internal rotation. Hip radiographic (rOA) was defined as a Kellgren-Lawrence grade of ≥2 in at least one hip. Participants completed questionnaires at baseline to determine presence of hip symptoms and covariate status. Participants with symptomatic hiprOA (SxOA) are a subset of individuals with hiprOA and symptoms in the same hip. Multiple imputation was used to impute missing values of covariates. Mortality was determined through 2015 and follow-up time was calculated from baseline assessment until death or censoring which took place when a participant was lost to follow-up or reached the end of study period. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). We carried out additional analyses stratified by sex, race, age and obesity. RESULTS: Mean follow-up time was 14.2 years during which 1762 deaths occurred. There were 29.9% participants in our population with hiprOA at baseline. Compared to those with neither hiprOA nor hip symptoms, we observed an increased risk of all-cause mortality in participants with hip symptoms alone (HR = 1.28, 95% CI = 1.13-1.46), but no association for hiprOA either with or without symptoms. In stratified analyses we observed increased associations for hip symptoms alone and hip sxOA in those <65 years (43% and 39% increase, respectively) and in Caucasians (34% and 21% increase, respectively). CONCLUSIONS: Individuals who had hip symptoms without hiprOA had an increased risk of mortality. These effects were particularly strong for those who were <65 years of age and Caucasians. Effective interventions to identify those with hip pain in order to lessen it could reduce premature mortality.
Authors: Joanne M Jordan; Charles G Helmick; Jordan B Renner; Gheorghe Luta; Anca D Dragomir; Janice Woodard; Fang Fang; Todd A Schwartz; Lauren M Abbate; Leigh F Callahan; William D Kalsbeek; Marc C Hochberg Journal: J Rheumatol Date: 2007-01 Impact factor: 4.666
Authors: Kamil E Barbour; Li-Yung Lui; Michael C Nevitt; Louise B Murphy; Charles G Helmick; Kristina A Theis; Marc C Hochberg; Nancy E Lane; Jennifer M Hootman; Jane A Cauley Journal: Arthritis Rheumatol Date: 2015-07 Impact factor: 10.995
Authors: K D Allen; C G Helmick; T A Schwartz; R F DeVellis; J B Renner; J M Jordan Journal: Osteoarthritis Cartilage Date: 2009-03-18 Impact factor: 6.576
Authors: Kirsten M Leyland; Lucy S Gates; Maria T Sanchez-Santos; Michael C Nevitt; David Felson; Graeme Jones; Joanne M Jordan; Andrew Judge; Dani Prieto-Alhambra; Noriko Yoshimura; Julia L Newton; Leigh F Callahan; Cyrus Cooper; Mark E Batt; Jianhao Lin; Qiang Liu; Rebecca J Cleveland; Gary S Collins; Nigel K Arden Journal: Aging Clin Exp Res Date: 2021-02-15 Impact factor: 3.636