Please use this identifier to cite or link to this item: https://doi.org/10.1136/bmjopen-2020-046713
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dc.titleInfluence of pre-existing multimorbidity on receiving a hip arthroplasty: cohort study of 28 025 elderly subjects from UK primary care
dc.contributor.authorFerguson, Rory
dc.contributor.authorPrieto-Alhambra, Daniel
dc.contributor.authorPeat, George
dc.contributor.authorDelmestri, Antonella
dc.contributor.authorJordan, Kelvin P
dc.contributor.authorStrauss, Vicky Y
dc.contributor.authorValderas, Jose Maria
dc.contributor.authorWalker, Christine
dc.contributor.authorYu, Dahai
dc.contributor.authorGlyn-Jones, Sion
dc.contributor.authorSilman, Alan
dc.date.accessioned2023-01-25T03:43:46Z
dc.date.available2023-01-25T03:43:46Z
dc.date.issued2021-09-01
dc.identifier.citationFerguson, 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
dc.identifier.issn2044-6055
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/236313
dc.description.abstractThe 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.
dc.language.isoen
dc.publisherBMJ PUBLISHING GROUP
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectMedicine, General & Internal
dc.subjectGeneral & Internal Medicine
dc.subjecthip
dc.subjecthealth policy
dc.subjectsurgery
dc.subjectgeriatric medicine
dc.subjectCOMORBIDITY
dc.subjectBENEFITS
dc.subjectRISKS
dc.typeArticle
dc.date.updated2023-01-20T10:27:26Z
dc.contributor.departmentDEPT OF MEDICINE
dc.description.doi10.1136/bmjopen-2020-046713
dc.description.sourcetitleBMJ OPEN
dc.description.volume11
dc.description.issue9
dc.published.statePublished
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