机构：[1]Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China[2]Department of Health research methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada[3]Department of Orthopedics No. 2 (Spinal Surgery), Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, China珠海院区骨科珠海门诊骨科广东省中医院[4]Toronto General Research Institute, University Health Network, Toronto, ON, Canada[5]Department of Medicine, McMaster University, Hamilton, ON, Canada[6]Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada[7]Division of Rheumatology, Mount Sinai Hospital, Toronto, ON, Canada
The evidence assessing the relationship between frailty and risk of adverse health outcomes in patients with rheumatoid arthritis (RA) remains limited and sparse in the literature. Data from the Ontario Best Practices Research Initiative (OBRI), a clinical registry of patients with RA, were used to explore the relationship between frailty and fracture risk in patients with RA. Patients were referred to OBRI by their participating rheumatologist, and contacted by OBRI trained interviewers. Primary outcome was time to first incident osteoporotic fractures during follow-up that led to a hospitalization or emergency room visit. Frailty was measured by a Rockwood-type frailty index (FI) of deficit accumulation that consisted of 32 health-related deficits. To quantify the relationship between frailty and risk of fracture, we used Cox proportional hazards models with hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) reported. We included 2923 patients (mean age 57.7 standard deviation [SD]: 12.7; 78% female,) for analyses. During a mean follow-up of 3.7 years, there were 125 (4.3%) incident fractures reported. The FI was significantly higher in patients with a fracture compared to controls (0.24 vs. 0.20, p = 0.02). The FI was found to be significantly related to increased risk of fracture in the fully-adjusted models, with a HR of 1.04 (95% CI: 1.02-1.06, p < 0.001) and 1.58 (95% CI: 1.32-1.89, p < 0.001) for per-0.01 and per-SD increase in the FI respectively. In summary, our study demonstrates that higher frailty status is significantly related to increased risk of osteoporotic fractures in patients with RA. Quantifying the frailty status as a research tool may aid in fracture risk assessment, management and decision making in RA.
基金：
OBRI is funded by the Canadian Institute for Health Research
(CIHR), Ontario Ministry of Health and Long-Term Care, Canadian
Arthritis Network, Abbvie, Amgen, Bristol Myers Squibb, Pfizer, UCB,
Janssen and Roche, Celgene, and Fresenius Kabi. GL received the
Michael G. DeGroote Fellowship Award in Clinical Research from
McMaster University (RFHSC 2000005835), the Post-doctoral
Fellowship Award from the Research Institute of St. Joe's Hamilton, and
research grants from the Science Foundation of Guangdong Second
Provincial General Hospital (YY2018-002).
第一作者机构：[1]Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China[2]Department of Health research methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada[*1]Guangdong Second Provincial General Hospital, 466 Newport Middle Road, Haizhu District, Guangzhou 510317, Guangdong Province, China[*2]Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main St West, Hamilton, ON L8S 4L8, Canada
共同第一作者：
通讯作者：
通讯机构：[1]Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China[2]Department of Health research methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada[*1]Guangdong Second Provincial General Hospital, 466 Newport Middle Road, Haizhu District, Guangzhou 510317, Guangdong Province, China[*2]Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main St West, Hamilton, ON L8S 4L8, Canada
推荐引用方式(GB/T 7714)：
Li Guowei,Chen Maoshui,Li Xiuying,et al.Frailty and risk of osteoporotic fractures in patients with rheumatoid arthritis: Data from the Ontario Best Practices Research Initiative[J].BONE.2019,127:129-134.doi:10.1016/j.bone.2019.06.006.
APA：
Li, Guowei,Chen, Maoshui,Li, Xiuying,Cesta, Angela,Lau, Arthur...&Bombardier, Claire.(2019).Frailty and risk of osteoporotic fractures in patients with rheumatoid arthritis: Data from the Ontario Best Practices Research Initiative.BONE,127,
MLA：
Li, Guowei,et al."Frailty and risk of osteoporotic fractures in patients with rheumatoid arthritis: Data from the Ontario Best Practices Research Initiative".BONE 127.(2019):129-134
