Prevalence of osteoarthritis in individuals with COPD: a systematic review

Figures & data

Figure 1 PRISMA flow diagram of the search and study selection.

Abbreviation: OA, osteoarthritis.

Table 1 Characteristics of the included studies with the timescale starting from the inception of the databases up to April 2017

Article	Study type	Population	Method of identification	Country	Race	Mean age in years (SD)	Females	Obesity (%)	Smoking status	% OA reported	Weighted mean
Schnell et al^Citation30	Cross- sectional	995 with COPD from NHANES	Search	USA	% (95% CI): White: 84.6 (81.4–87.4); Black: 6.8 (5.1–8.9); Hispanic: 4.4 (3.0–6.3)	62.7 (95% CI 61.7–63.8)	60.1%	40.3%	Ever smoked (68.9%); >10 pack-years (43%)	54.6%	0.54%
Westerik et al^Citation31	Retrospective cohort study	14,603 with COPD from health records in Dutch general practices	Search	the Netherlands	Not reported	66.5 (SD 11.5)	46.9%	4.4%	Not reported	17.6%	2.53%
Rai et al^Citation32	Cross- sectional	608 with COPD out of 1,889 from Birmingham COPD cohort study	Manual search	UK	Not reported	Age: 38–49 (11.2%); 50–59 (41.6%); 60–64; (47.2%)	43.6%	BMI (kg/m^2): underweight (<18.5) = 2.8%; normal weight (18.5–24.9) = 26.8%; overweight (25.0–29) = 35.2%; obese (30.0–39) = 29.6%; morbidly obese (>40.0) = 5.7%	Current smokers (49.7%); ex-smokers (42.8%); never smoked (7.5%)	16.8%	0.10%
Lee et al^Citation33	Cohort study	15,540 with COPD (55–64 years) from National Veterans Health Administration database	Manual search	USA	Not reported	59.3 (3.1)	Not reported (mostly males)	Not reported	Not reported	20%	3.07%
Garin et al^Citation34	Cross- sectional study	3,339 with COPD from 41,909 adults >50 years from nine countries	Search	Nine countries: China, Ghana, India, Mexico, Russia, South Africa, Finland, Spain and Poland	Not reported	Not reported	Not reported	19%	Not reported	44%	1.45%
Kumbhare et al^Citation35	Cross- sectional, observational study	4,807 with COPD from the 2012 BRFSS, an annual random digit-dialed telephone survey	Search	USA	White, non- Hispanic (82.9%); Black, non-Hispanic (8.2%); other race, non- Hispanic (3%); multiracial, non- Hispanic (2.8%); Hispanic (1.8%)	67.1 (SD 11.8)	61.6%	BMI (kg/m^2) categories: underweight (<18.5) = 7%; normal weight (18.5–24.9) = 29.8%; overweight (25.0–29.9) = 30.9%; obese (30.0–39.9) = 26.3%; morbidly obese (>40.0) = 6.1%	Current smokers (34.3%); ex-smokers (45.5%); never smoked (20.2%)	61.2%	2.9%
Lalkhen and Mash^Citation36	Cross- sectional study	140 with COPD from primary health care facilities in South Africa	Search	South Africa	Not reported	Not reported	Not reported	Not reported	Not reported	12.1%	0.02%
Park et al^Citation37,*	Retrospective cohort	1,905 with COPD from the database of the fourth and fifth (2007–2012) KNHANES	Search	Korea	Not reported	64.5 (10.2)	32%	BMI (kg/m^2) categories (<18.5) = 3.3%; (18.5–23.0) = 68.2%; (≥23.0) = 28.5%	Current smokers (39.6%); ex-smokers (17.6%); never smoked (42.8%)	11.9%	0.22%
Putcha et al^Citation38	Cohort study	3,690 African- Americans and non-Hispanic Whites among GOLD 2–4 COPD patients	Search	USA	African- Americans (23%); non- Hispanic Whites (77%)	63.4 (8.5)	44%	Mean BMI (SD) 28.1 (6.3)	Current smokers (40.7%)	20.7% (calculated not reported)	0.75%
Schwab et al^Citation39	Retrospective cohort study	52,643 with COPD from US claims database (Humana Inc., Louisville, KY, USA)	Search	USA	Not reported	70.6 (9.6)	55%	19.65%	Not reported	43.8%	22.7%
Mapel et al^Citation40,**	Case–control study	200 with COPD from 1,522 from the Managed Care Database, New Mexico	Manual search	USA	Hispanic (17.8%); non- Hispanic (82.2%)	67.5	48.9%	Not reported	Current smokers (46%); ex-smokers (34%); never smoked (14.5%)	22% (moderate- to-severe arthritis only)	0.04%
Wijnhoven et al^Citation41	Cross- sectional study	161 with COPD from 25 primary care practices in the Netherlands	Manual search	the Netherlands	Not reported	61 (10.3)	44.7%	Not reported	Not reported	23%	0.04%
Yeo et al^Citation42	Observational cohort study	27 with COPD ≥70 years from the UK primary care	Manual search	UK	Not reported	76 (4.36)	40.7%	Not reported	Not reported	74%	0.02%
Karch et al^Citation43	Cohort study	2,741 with COPD from 31 centers in Germany	Manual search	Germany	Not reported	65.1 (8.6)	41%	Mean BMI (SD) 27.0 (5.4)	Current smokers (24%); ex-smokers (68%); never smoked (8%)	40.1%	1.08%
		Total = 101,399									Total = 35.5%

Notes:

* The characteristics of the percentage of males and the mean age are for the overall sample in the original study (n = 2,108) not for the patients included in our analysis (n = 1,905).

** The characteristics of the percentage of males and the mean age are for the overall sample in the original study (n = 1,522) not for the patients included in our analysis (n = 200). Smoking history not documented for 5.5% of the patients.

Abbreviations: BMI, body mass index; BRFSS, Behavioral Risk Factor Surveillance System; KNHANES, Korean National Health and Nutrition Examination Survey; NHANES, National Health and Nutritional Examination Study; OA, osteoarthritis; GOLD, Global Initiative for Obstructive Lung Disease scale.

Table 2 The quality assessment results for the included articles starting from the inception of the databases to April 2017

Article	1. Sample frame appropriate to target population?	2. Study participants sampled in an appropriate way?	3. Sample size adequate?	4. Study subjects and setting described in detail?	5. Analysis conducted with sufficient coverage of the identified sample?	6. Valid methods to identify condition?	7. Condition measured in a standard, reliable way?	8. Appropriate statistical analysis?	9. Response rate adequate or was low response rate managed appropriately?
Schnell et al^Citation30	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes
Westerik et al^Citation31	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Not applicable
Rai et al^Citation32	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Not applicable
Lee et al^Citation33	Yes	Yes	Yes	Yes	Yes	Yes	Unclear	Yes	Not applicable
Garin et al^Citation34	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Not applicable
Kumbhare et al^Citation35	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Not applicable
Lalkhen and Mash^Citation36	Yes	No	Yes	Yes	Unclear	No	No	Unclear	Not applicable
Park et al^Citation37	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Not applicable
Putcha et al^Citation38	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Not applicable
Schwab et al^Citation39	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Not applicable
Mapel et al^Citation40	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Not applicable
Wijnhoven et al^Citation41	Yes	Yes	Unclear	Yes	Yes	No	Yes	Yes	No
Yeo et al^Citation42	No	Yes	No	Yes	No	No	Yes	Yes	No
Karch et al^Citation43	Yes	Yes	Yes	Yes	Yes	No	Yes	Yes	Not applicable

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