Hip pain predicts OA mortality beyond comorbidities

 

LIVERPOOL, ENGLAND – Hip pain increases all-cause mortality in people with OA by a third, according to data obtained from a large, community-based study.

The hazard ratio for all-cause mortality was 1.33 (95% confidence interval, 1.17-1.51) in people who self-reported hip pain over the course of up to 25 years’ follow-up. The presence of hip pain also increased the risk of cardiovascular mortality (HR, 1.22; 95% CI, 0.99-1.50).

Sara Freeman/MDedge News

“The finding that hip pain more than radiographic hip OA is associated with mortality warrants further investigation,” said study investigator Rebecca J. Cleveland, PhD, at the World Congress on Osteoarthritis.

The hazard ratios for all-cause and cardiovascular mortality in patients with radiographic hip pain were 1.04 (95% CI, 0.91-1.17) and 1.01(95% CI, 0.82-1.24), and the all-cause and cardiovascular mortality hazard ratios in patients with both hip pain and radiographic OA were 1.01 (95% CI, 0.87-1.18) and 1.01 (95% CI, 0.80-1.28).

These data support hip pain as a predictor of mortality, observed Dr. Cleveland, of the University of North Carolina at Chapel Hill. “While there have been a number of studies that have looked at osteoarthritis as a risk factor for mortality, a lot of these studies have looked at arthritis in general or have looked at specifically knee osteoarthritis.

“There have been only a handful of studies that have looked at hip osteoarthritis as a risk factor for mortality,” she added, and considered all together, the results have been equivocal.

The aim of the current study she presented at the congress sponsored by the Osteoarthritis Research Society International was to explore whether or not hip OA was associated with all-cause and cardiovascular disease–specific mortality, independent of any comorbidities. The comorbidities considered were cancer, liver disease, hypertension, type 2 diabetes mellitus, and cardiovascular disease.

 

Data on 3,919 people with and without hip OA were obtained from the Johnston County Osteoarthritis Project, a longitudinal cohort of white and African American residents aged 45 years or older. Enrollment was carried out in two waves, with 3,185 people recruited between 1990 and 1998 and 1,015 people recruited between 2003 and 2004. Only those with baseline and follow-up assessment data, including at least one hip radiograph, were included in the present analysis.

The mean age at recruitment was 62 years, 61% were women, and two-thirds were white. Around 17% (n = 655) had radiographic hip OA and hip pain (symptomatic OA) at baseline, 10% (n = 787) had radiographic OA alone, and 27% (n = 1,156) had hip pain alone. The remaining 45% (n = 1,321) had neither hip pain nor radiographic damage.

Over the course of up to 25 years’ follow-up, there were 1,762 deaths from any cause – 311 occurred in the group with symptomatic OA at baseline, 382 in the group with radiographic OA alone, 509 in those with hip pain alone, and 560 in those with neither hip pain nor radiographic OA.

Median survival was lowest in individuals with symptomatic OA, at 16.1 years, and highest in individuals without either, at 22.8 years. Median survival was similar for those with hip pain only (18.6 years) and with radiographic hip OA only (18.5 years).

 

Stratified by race, all-cause mortality was increased with hip pain alone, and was more pronounced in white patients (HR, 1.39) than in African American patients (HR, 1.24). Interestingly, the risk of all-cause death was lower in African American patients who had symptomatic hip OA than their white counterparts (HR, 0.78 and 1.16, respectively).

Furthermore, Dr. Cleveland reported that hip pain was strongly associated with all-cause mortality in those younger than 65 years (HR, 1.56) when compared with those who were 65 years and up (HR, 1.18). Of note, the risk of death was higher in younger patients with symptomatic hip pain than in older patients (HR, 1.33 and 0.88, respectively).

A 41% increased death risk was also observed in patients with hip pain who had a body mass index of 30 kg/m² (HR, 1.41 vs. HR, 1.29 for those with hip pain and a body mass index of less than 30 kg/m²).

“Our results are independent of comorbidities and sociodemographic measures,” Dr. Cleveland said. “This suggests there are mechanisms beyond comorbidities in the link between radiographic hip OA and mortality risk.”

 

The Johnston County Osteoarthritis Project is funded by the Centers for Disease Control and Prevention and the National Institutes of Arthritis and Musculoskeletal and Skin Diseases. Dr. Cleveland had no conflicts of interest to report.

SOURCE: Cleveland RJ et al. Osteoarthritis Cartilage. 2018:26(1):S10-1. Abstract 1.

 

LIVERPOOL, ENGLAND – Hip pain increases all-cause mortality in people with OA by a third, according to data obtained from a large, community-based study.

The hazard ratio for all-cause mortality was 1.33 (95% confidence interval, 1.17-1.51) in people who self-reported hip pain over the course of up to 25 years’ follow-up. The presence of hip pain also increased the risk of cardiovascular mortality (HR, 1.22; 95% CI, 0.99-1.50).

Sara Freeman/MDedge News

“The finding that hip pain more than radiographic hip OA is associated with mortality warrants further investigation,” said study investigator Rebecca J. Cleveland, PhD, at the World Congress on Osteoarthritis.

The hazard ratios for all-cause and cardiovascular mortality in patients with radiographic hip pain were 1.04 (95% CI, 0.91-1.17) and 1.01(95% CI, 0.82-1.24), and the all-cause and cardiovascular mortality hazard ratios in patients with both hip pain and radiographic OA were 1.01 (95% CI, 0.87-1.18) and 1.01 (95% CI, 0.80-1.28).

These data support hip pain as a predictor of mortality, observed Dr. Cleveland, of the University of North Carolina at Chapel Hill. “While there have been a number of studies that have looked at osteoarthritis as a risk factor for mortality, a lot of these studies have looked at arthritis in general or have looked at specifically knee osteoarthritis.

“There have been only a handful of studies that have looked at hip osteoarthritis as a risk factor for mortality,” she added, and considered all together, the results have been equivocal.

The aim of the current study she presented at the congress sponsored by the Osteoarthritis Research Society International was to explore whether or not hip OA was associated with all-cause and cardiovascular disease–specific mortality, independent of any comorbidities. The comorbidities considered were cancer, liver disease, hypertension, type 2 diabetes mellitus, and cardiovascular disease.

 

Data on 3,919 people with and without hip OA were obtained from the Johnston County Osteoarthritis Project, a longitudinal cohort of white and African American residents aged 45 years or older. Enrollment was carried out in two waves, with 3,185 people recruited between 1990 and 1998 and 1,015 people recruited between 2003 and 2004. Only those with baseline and follow-up assessment data, including at least one hip radiograph, were included in the present analysis.

The mean age at recruitment was 62 years, 61% were women, and two-thirds were white. Around 17% (n = 655) had radiographic hip OA and hip pain (symptomatic OA) at baseline, 10% (n = 787) had radiographic OA alone, and 27% (n = 1,156) had hip pain alone. The remaining 45% (n = 1,321) had neither hip pain nor radiographic damage.

Over the course of up to 25 years’ follow-up, there were 1,762 deaths from any cause – 311 occurred in the group with symptomatic OA at baseline, 382 in the group with radiographic OA alone, 509 in those with hip pain alone, and 560 in those with neither hip pain nor radiographic OA.

Median survival was lowest in individuals with symptomatic OA, at 16.1 years, and highest in individuals without either, at 22.8 years. Median survival was similar for those with hip pain only (18.6 years) and with radiographic hip OA only (18.5 years).

 

Stratified by race, all-cause mortality was increased with hip pain alone, and was more pronounced in white patients (HR, 1.39) than in African American patients (HR, 1.24). Interestingly, the risk of all-cause death was lower in African American patients who had symptomatic hip OA than their white counterparts (HR, 0.78 and 1.16, respectively).

Furthermore, Dr. Cleveland reported that hip pain was strongly associated with all-cause mortality in those younger than 65 years (HR, 1.56) when compared with those who were 65 years and up (HR, 1.18). Of note, the risk of death was higher in younger patients with symptomatic hip pain than in older patients (HR, 1.33 and 0.88, respectively).

A 41% increased death risk was also observed in patients with hip pain who had a body mass index of 30 kg/m² (HR, 1.41 vs. HR, 1.29 for those with hip pain and a body mass index of less than 30 kg/m²).

“Our results are independent of comorbidities and sociodemographic measures,” Dr. Cleveland said. “This suggests there are mechanisms beyond comorbidities in the link between radiographic hip OA and mortality risk.”

 

The Johnston County Osteoarthritis Project is funded by the Centers for Disease Control and Prevention and the National Institutes of Arthritis and Musculoskeletal and Skin Diseases. Dr. Cleveland had no conflicts of interest to report.

SOURCE: Cleveland RJ et al. Osteoarthritis Cartilage. 2018:26(1):S10-1. Abstract 1.

 

LIVERPOOL, ENGLAND – Hip pain increases all-cause mortality in people with OA by a third, according to data obtained from a large, community-based study.

The hazard ratio for all-cause mortality was 1.33 (95% confidence interval, 1.17-1.51) in people who self-reported hip pain over the course of up to 25 years’ follow-up. The presence of hip pain also increased the risk of cardiovascular mortality (HR, 1.22; 95% CI, 0.99-1.50).

Sara Freeman/MDedge News

“The finding that hip pain more than radiographic hip OA is associated with mortality warrants further investigation,” said study investigator Rebecca J. Cleveland, PhD, at the World Congress on Osteoarthritis.

The hazard ratios for all-cause and cardiovascular mortality in patients with radiographic hip pain were 1.04 (95% CI, 0.91-1.17) and 1.01(95% CI, 0.82-1.24), and the all-cause and cardiovascular mortality hazard ratios in patients with both hip pain and radiographic OA were 1.01 (95% CI, 0.87-1.18) and 1.01 (95% CI, 0.80-1.28).

These data support hip pain as a predictor of mortality, observed Dr. Cleveland, of the University of North Carolina at Chapel Hill. “While there have been a number of studies that have looked at osteoarthritis as a risk factor for mortality, a lot of these studies have looked at arthritis in general or have looked at specifically knee osteoarthritis.

“There have been only a handful of studies that have looked at hip osteoarthritis as a risk factor for mortality,” she added, and considered all together, the results have been equivocal.

The aim of the current study she presented at the congress sponsored by the Osteoarthritis Research Society International was to explore whether or not hip OA was associated with all-cause and cardiovascular disease–specific mortality, independent of any comorbidities. The comorbidities considered were cancer, liver disease, hypertension, type 2 diabetes mellitus, and cardiovascular disease.

 

Data on 3,919 people with and without hip OA were obtained from the Johnston County Osteoarthritis Project, a longitudinal cohort of white and African American residents aged 45 years or older. Enrollment was carried out in two waves, with 3,185 people recruited between 1990 and 1998 and 1,015 people recruited between 2003 and 2004. Only those with baseline and follow-up assessment data, including at least one hip radiograph, were included in the present analysis.

The mean age at recruitment was 62 years, 61% were women, and two-thirds were white. Around 17% (n = 655) had radiographic hip OA and hip pain (symptomatic OA) at baseline, 10% (n = 787) had radiographic OA alone, and 27% (n = 1,156) had hip pain alone. The remaining 45% (n = 1,321) had neither hip pain nor radiographic damage.

Over the course of up to 25 years’ follow-up, there were 1,762 deaths from any cause – 311 occurred in the group with symptomatic OA at baseline, 382 in the group with radiographic OA alone, 509 in those with hip pain alone, and 560 in those with neither hip pain nor radiographic OA.

Median survival was lowest in individuals with symptomatic OA, at 16.1 years, and highest in individuals without either, at 22.8 years. Median survival was similar for those with hip pain only (18.6 years) and with radiographic hip OA only (18.5 years).

 

Stratified by race, all-cause mortality was increased with hip pain alone, and was more pronounced in white patients (HR, 1.39) than in African American patients (HR, 1.24). Interestingly, the risk of all-cause death was lower in African American patients who had symptomatic hip OA than their white counterparts (HR, 0.78 and 1.16, respectively).

Furthermore, Dr. Cleveland reported that hip pain was strongly associated with all-cause mortality in those younger than 65 years (HR, 1.56) when compared with those who were 65 years and up (HR, 1.18). Of note, the risk of death was higher in younger patients with symptomatic hip pain than in older patients (HR, 1.33 and 0.88, respectively).

A 41% increased death risk was also observed in patients with hip pain who had a body mass index of 30 kg/m² (HR, 1.41 vs. HR, 1.29 for those with hip pain and a body mass index of less than 30 kg/m²).

“Our results are independent of comorbidities and sociodemographic measures,” Dr. Cleveland said. “This suggests there are mechanisms beyond comorbidities in the link between radiographic hip OA and mortality risk.”

 

The Johnston County Osteoarthritis Project is funded by the Centers for Disease Control and Prevention and the National Institutes of Arthritis and Musculoskeletal and Skin Diseases. Dr. Cleveland had no conflicts of interest to report.

SOURCE: Cleveland RJ et al. Osteoarthritis Cartilage. 2018:26(1):S10-1. Abstract 1.