Mortality in osteoarthritis patients

Abstract

Objectives: To investigate whether all-cause mortality and deaths due to cardiovascular disease are increased in patients who have consulted primary or secondary health care with symptoms and signs of osteoarthritis (OA).

Method: This study included 383 patients with symptomatic OA at multiple sites from the Genetics ARthrosis and Progression (GARP) study (mean age 60 years, 82% women, 3693 person-years of follow-up) and 459 patients with primary hand, knee, or hip OA from the Osteoarthritis Care Clinic (OCC) study (mean age 61 years, 88% women, 1890 person-years of follow-up). Standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) were calculated for all-cause mortality and causes of deaths in comparison to the general population. Cox proportional hazard ratios (HRs) with 95% CIs were used to associate baseline characteristics with all-cause mortality.

Results: In the GARP study, 26 patients died whereas 48 deaths were expected (SMR 0.54, 95% CI 0.37–0.79). The SMR was 0.47 (95% CI 0.29–0.76) in women and 0.73 (95% CI 0.39–1.35) in men. Similar results were found in the OCC study (SMR 0.45, 95% CI 0.25–0.82). Malignancy and cardiovascular disease were the main causes of deaths in GARP. Male sex (HR 3.04, 95% CI 1.38–6.69), increasing age (HR 1.10, 95% CI 1.05–1.16), and self-reported cancer (HR 8.29, 95% CI 3.12–22.03) were associated with increased mortality in GARP.

Conclusions: Patients consulting health care for their OA are not at higher risk of death than the general population. These results suggest that the management of OA patients may not need to focus specifically on the treatment of cardiovascular risk factors and comorbidities.

Acknowledgements

We thank Dr L E Flinterman for assistance in statistical analyses.