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Lifetime risk of knee and hip replacement following a diagnosis of RA: findings from a cohort of 13,961 patients from England

Lifetime risk of knee and hip replacement following a diagnosis of RA: findings from a cohort of 13,961 patients from England
Lifetime risk of knee and hip replacement following a diagnosis of RA: findings from a cohort of 13,961 patients from England

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.
1462-0324
1950-1954
Burn, E.
fa7e0782-cffc-479a-a41f-ba337a6554dc
Edwards, C.J.
d19255c4-eacd-4052-985b-dd522b06a8ab
Murray, David W.
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Silman, Alan J.
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Cooper, Cyrus
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Arden, Nigel
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Pinedo-Villanueva, R.
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Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Burn, E.
fa7e0782-cffc-479a-a41f-ba337a6554dc
Edwards, C.J.
d19255c4-eacd-4052-985b-dd522b06a8ab
Murray, David W.
fa0e1764-e600-42bd-937d-6d7e5d623bbc
Silman, Alan J.
1ab1fc13-51f5-44c8-92f1-0bb32a5c5754
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Pinedo-Villanueva, R.
ec8ed49e-bf51-435b-a6ce-5a23da325b3c
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9

Burn, E., Edwards, C.J., Murray, David W., Silman, Alan J., Cooper, Cyrus, Arden, Nigel, Pinedo-Villanueva, R. and Prieto-Alhambra, Daniel (2019) Lifetime risk of knee and hip replacement following a diagnosis of RA: findings from a cohort of 13,961 patients from England. Rheumatology, 58 (11), 1950-1954. (doi:10.1093/rheumatology/kez143).

Record type: Article

Abstract


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.

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More information

Accepted/In Press date: 16 March 2019
e-pub ahead of print date: 23 April 2019
Published date: November 2019

Identifiers

Local EPrints ID: 431489
URI: http://eprints.soton.ac.uk/id/eprint/431489
ISSN: 1462-0324
PURE UUID: c0255e30-88be-417e-b8ff-94206068062d
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 05 Jun 2019 16:30
Last modified: 26 Nov 2021 05:06

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Contributors

Author: E. Burn
Author: C.J. Edwards
Author: David W. Murray
Author: Alan J. Silman
Author: Cyrus Cooper ORCID iD
Author: Nigel Arden
Author: R. Pinedo-Villanueva
Author: Daniel Prieto-Alhambra

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