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Mortality in osteoarthritis

Issue 33 (Summer 2011)

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Although the excess mortality associated with rheumatoid arthritis – mainly as a result of cardiovascular disease (CVD) – is well known, osteoarthritis (OA) has not been thought to be associated with increased mortality. A study published in BMJ1 should however change this perception. A cohort study following 1163 patients with OA of the hip or knee for a median of 14 years demonstrated a 55% excess in all-cause mortality. Most of the excess mortality was due to CVD and dementia-related disease. Predictably a history of cancer, diabetes and CVD were major risk factors but mortality was most strongly associated with walking disability – the greater the impaired ability to walk, the greater the risk of earlier death. Clearly, increasing physical activity should therefore be a major goal in management of OA hip and knee. Of course we cannot be totally sure that the treatment of OA did not contribute to the mortality figures – see below.

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