Lifetime risk of knee and hip replacement following a diagnosis of RA : findings from a cohort of 13 961 patients from England
Burn, Edward (Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences. University of Oxford)
Edwards, Christopher J. (University Hospital Southampton NHS Foundation Trust (Regne Unit))
Murray, David W. (Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences. University of Oxford)
Silman, Alan (Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences. University of Oxford)
Cooper, Cyrus (MRC Lifecourse Epidemiology Unit. Southampton University)
Arden, N. K (MRC Lifecourse Epidemiology Unit. Southampton University)
Pinedo-Villanueva, Rafael (Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences. University of Oxford)
Prieto-Alhambra, Daniel (Universitat Autònoma de Barcelona)

Fecha:	2019
Resumen:	Objective: To estimate the lifetime risk of knee and hip replacement following a diagnosis of RA. Methods: The analysis was undertaken using routinely collected data from the English NHS. Diagnosis of RA was identified using primary care records, with knee and hip replacement observed in linked hospital records. Parametric survival models were fitted for up to 15 years of follow-up, with age, sex, Charlson comorbidity score, socioeconomic status, BMI and smoking status included as explanatory variables. A decision model was used to combine and extrapolate survival models to estimate lifetime risk. Results: The number of individuals with a diagnosis of RA and included in the study was 13 961. Lifetime risk of knee replacement and hip replacement was estimated to be 22% (95% CI: 16, 29%) and 17% (95% CI: 11, 26%) following a diagnosis of RA for the average patient profile (non-smoking women aged 64 with no other comorbidities, BMI of 27 and in the top socioeconomic quintile). Risks were higher for younger patients. Conclusion: The lifetime risk of knee and hip replacement for individuals with a diagnosis of RA is approximately double that of the general population. These findings allow for a better understanding of long-term prognosis and healthcare resource use, and highlight the importance of timely diagnosis and effective treatment.
Nota:	Funding: This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. This work was supported by the NIHR Biomedical Research Centre, Oxford
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Rheumatoid arthritis ; Surgery ; Epidemiology ; Knee ; Hip
Publicado en:	Rheumatology, Vol. 58 (2019) , p. 1950-1954, ISSN 1462-0332

DOI: 10.1093/rheumatology/kez143
PMID: 31127844

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