Please use this identifier to cite or link to this item: https://doi.org/10.1136/bmjopen-2020-046713
Title: Influence of pre-existing multimorbidity on receiving a hip arthroplasty: cohort study of 28 025 elderly subjects from UK primary care
Authors: Ferguson, Rory
Prieto-Alhambra, Daniel
Peat, George
Delmestri, Antonella
Jordan, Kelvin P
Strauss, Vicky Y
Valderas, Jose Maria 
Walker, Christine
Yu, Dahai
Glyn-Jones, Sion
Silman, Alan
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
hip
health policy
surgery
geriatric medicine
COMORBIDITY
BENEFITS
RISKS
Issue Date: 1-Sep-2021
Publisher: BMJ PUBLISHING GROUP
Citation: Ferguson, Rory, Prieto-Alhambra, Daniel, Peat, George, Delmestri, Antonella, Jordan, Kelvin P, Strauss, Vicky Y, Valderas, Jose Maria, Walker, Christine, Yu, Dahai, Glyn-Jones, Sion, Silman, Alan (2021-09-01). Influence of pre-existing multimorbidity on receiving a hip arthroplasty: cohort study of 28 025 elderly subjects from UK primary care. BMJ OPEN 11 (9). ScholarBank@NUS Repository. https://doi.org/10.1136/bmjopen-2020-046713
Abstract: The median age for total hip arthroplasty (THA) is over 70 years with the corollary that many individuals have multiple multimorbidities. Despite the predicted improvement in quality of life, THA might be denied even to those with low levels of multimorbidity. Objective To evaluate how pre-existing levels of multimorbidity influence the likelihood and timing of THA. Setting Longitudinal record linkage study of a UK sample linking their primary care to their secondary care records. Participants A total of 28 025 patients were included, based on the recording of the diagnosis of hip osteoarthritis in a national primary care register, Clinical Practice Research Datalink. Data were extracted from the database on background health and morbidity status using five different constructs: Charlson Comorbidity Index, Electronic Frailty Index and counts of chronic diseases (from list of 17), prescribed medications and number of primary care visits prior to recording of osteoarthritis. Outcome measures The record of having received a THA as recorded in the primary care record and the linked secondary care database: Hospital Episode Statistics. Results 40% had THA: median follow 10 months (range 1-17 years). Increased multimorbidity was associated with a decreased likelihood of undergoing THA, irrespective of the method of assessing multimorbidity although the impact varied by approach. Conclusion Markers of pre-existing ill health influence the decision for THA in the elderly with end-stage hip osteoarthritis, although these effects are modest for indices of multimorbidity other than eFI. There is evidence of this influence being present even in people with moderate decrements in their health, despite the balance of benefits to risk in these individuals being positive.
Source Title: BMJ OPEN
URI: https://scholarbank.nus.edu.sg/handle/10635/236313
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2020-046713
Appears in Collections:Staff Publications
Elements

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
Influence of pre-existing multimorbidity on receiving a hip arthroplasty cohort study of 28 025 elderly subjects from UK pri.pdfPublished version533.2 kBAdobe PDF

OPEN

NoneView/Download

SCOPUSTM   
Citations

3
checked on Jan 25, 2023

Page view(s)

6
checked on Jan 26, 2023

Download(s)

1
checked on Jan 26, 2023

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.