Clustering of comorbidities and associated outcomes in people with osteoarthritis - A UK Clinical Practice Research Datalink study. Swain, S., Coupland, C., Strauss, V., Mallen, C., Kuo, C. F., Sarmanova, A., Bierma-Zeinstra, S. M. A., Englund, M., Prieto-Alhambra, D., Doherty, M., & Zhang, W. Osteoarthritis and Cartilage, 30(5):702–713, May, 2022.
Clustering of comorbidities and associated outcomes in people with osteoarthritis - A UK Clinical Practice Research Datalink study [link]Paper  doi  abstract   bibtex   
Objective To examine the clusters of chronic conditions present in people with osteoarthritis and the associated risk factors and health outcomes. Methods Clinical Practice Research Datalink (CPRD) GOLD was used to identify people diagnosed with incident osteoarthritis (n = 221,807) between 1997 and 2017 and age (±2 years), gender, and practice matched controls (no osteoarthritis, n = 221,807) from UK primary care. Clustering of people was examined for 49 conditions using latent class analysis. The associations between cluster membership and covariates were quantified by odds ratios (OR) using multinomial logistic regression. General practice (GP) consultations, hospitalisations, and all-cause mortality rates were compared across the clusters identified at the time of first diagnosis of osteoarthritis (index date). Results In both groups, conditions largely grouped around five clusters: relatively healthy; cardiovascular (CV), musculoskeletal-mental health (MSK-MH), CV-musculoskeletal (CV-MSK) and metabolic (MB). In the osteoarthritis group, compared to the relatively healthy cluster, strong associations were seen for 1) age with all clusters; 2) women with the MB cluster (OR 5.55: 5.14–5.99); 3) obesity with the CV-MSK (OR 2.11: 2.03–2.20) and CV clusters (OR 2.03: 1.97–2.09). The CV-MSK cluster in the osteoarthritis group had the highest number of GP consultations and hospitalisations, and the mortality risk was 2.45 (2.33–2.58) times higher compared to the relatively healthy cluster. Conclusions Of the five identified clusters, CV-MSK, CV, and MSK-MH are more common in OA and CV-MSK cluster had higher health utilisation. Further research is warranted to better understand the mechanistic pathways and clinical implications.
@article{swain_clustering_2022,
	title = {Clustering of comorbidities and associated outcomes in people with osteoarthritis - {A} {UK} {Clinical} {Practice} {Research} {Datalink} study},
	volume = {30},
	issn = {1063-4584},
	url = {https://www.sciencedirect.com/science/article/pii/S1063458422000139},
	doi = {10.1016/j.joca.2021.12.013},
	abstract = {Objective
To examine the clusters of chronic conditions present in people with osteoarthritis and the associated risk factors and health outcomes.
Methods
Clinical Practice Research Datalink (CPRD) GOLD was used to identify people diagnosed with incident osteoarthritis (n = 221,807) between 1997 and 2017 and age (±2 years), gender, and practice matched controls (no osteoarthritis, n = 221,807) from UK primary care. Clustering of people was examined for 49 conditions using latent class analysis. The associations between cluster membership and covariates were quantified by odds ratios (OR) using multinomial logistic regression. General practice (GP) consultations, hospitalisations, and all-cause mortality rates were compared across the clusters identified at the time of first diagnosis of osteoarthritis (index date).
Results
In both groups, conditions largely grouped around five clusters: relatively healthy; cardiovascular (CV), musculoskeletal-mental health (MSK-MH), CV-musculoskeletal (CV-MSK) and metabolic (MB). In the osteoarthritis group, compared to the relatively healthy cluster, strong associations were seen for 1) age with all clusters; 2) women with the MB cluster (OR 5.55: 5.14–5.99); 3) obesity with the CV-MSK (OR 2.11: 2.03–2.20) and CV clusters (OR 2.03: 1.97–2.09). The CV-MSK cluster in the osteoarthritis group had the highest number of GP consultations and hospitalisations, and the mortality risk was 2.45 (2.33–2.58) times higher compared to the relatively healthy cluster.
Conclusions
Of the five identified clusters, CV-MSK, CV, and MSK-MH are more common in OA and CV-MSK cluster had higher health utilisation. Further research is warranted to better understand the mechanistic pathways and clinical implications.},
	number = {5},
	urldate = {2023-09-12},
	journal = {Osteoarthritis and Cartilage},
	author = {Swain, S. and Coupland, C. and Strauss, V. and Mallen, C. and Kuo, C. F. and Sarmanova, A. and Bierma-Zeinstra, S. M. A. and Englund, M. and Prieto-Alhambra, D. and Doherty, M. and Zhang, W.},
	month = may,
	year = {2022},
	keywords = {Clusters, Comorbidity, Health utilisation, Osteoarthritis, Primary care, UK},
	pages = {702--713},
}

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