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Hip pain shows modest association with mortality
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LIVERPOOL, England — Hip pain demonstrated mild associations with both all-cause and cardiovascular-specific mortality in an analysis of community-based participants from the Johnston County cohort, according to findings presented here.
Rebecca J. Cleveland, PhD, assistant professor of medicine in the division of rheumatology, allergy and immunology at the Thurston Arthritis Research Center at the University of North Carolina, Chapel Hill, and colleagues explored whether hip osteoarthritis measures are associated with all-cause and cardiovascular-specific mortality. “Individuals with hip osteoarthritis tend to have functional limitations that lead to reduced physical activity,” she said. “Walking disability itself is associated with increased mortality.”
The 3,919 patients in the current data set were enrolled in two waves: one during 1991 to 1997 and the other during 2003 to 2004. They were assigned to one of four categories: neither radiographic hip OA nor hip pain; hip pain only; radiographic hip OA only; and both radiographic hip OA and hip pain.
The researchers controlled for a number of factors, including age, enrollment wave, birth cohort, sex, race, education and comorbidities.
Survival among patients with neither radiographic hip OA nor hip pain was 22.8 years, while survival was 18.6 years in the hip pain only group, 18.5 years in the radiographic hip OA group, and 16.1 years for patients with both radiographic hip OA and hip pain.
Adjusted analysis results indicated that in comparison with individuals with neither radiographic hip OA nor hip pain, all-cause mortality was statistically significantly elevated among patients with hip pain only (HR = 1.33; 95% CI, 1.17-1.51), but not among those with radiographic hip OA (HR = 1.04; 95% CI, 0.91-1.17).
Hip pain alone carried a nonsignificant association with cardiovascular mortality overall compared with patients with neither radiographic hip OA nor hip pain (HR = 1.22; 95% CI, 0.99-1.50).
Cleveland noted that in patients younger than 65 years, hip pain alone was more strongly associated with all-cause mortality (HR = 1.56; 95% CI, 1.29-1.88) compared with those older than 65 years (HR = 1.18; 95% CI, 1-1.39). Patients younger than 65 years with hip pain only also were at significant risk for cardiovascular mortality (HR = 1.73; 95% CI, 1.24-2.42).
Analysis by gender revealed no differences in survival between men and women, according to Cleveland. Similarly, race played no role in survival (HR = 1.24 for black individuals and 1.39 for whites).
“Hip pain is modestly associated with increased risk of all-cause and CVD-specific mortality,” Cleveland said. “This finding was consistent in all stratified analyses. This conclusion supports the hypothesis that hip pain is a predictor of mortality.” – by Rob Volansky
Reference:
Cleveland RJ, et al. Abstract #1. Presented at: OARSI 2018 World Congress on Osteoarthritis; April 26-29; Liverpool, England.
Disclosure: Cleveland reports no relevant financial disclosures.