All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study
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OBJECTIVE: To examine all cause and disease specific mortality in patients with osteoarthritis of the knee or hip. DESIGN: Population based cohort study. SETTING: General practices in the southwest of England. PARTICIPANTS: 1163 patients aged 35 years or over with symptoms and radiological confirmation of osteoarthritis of the knee or hip. MAIN OUTCOME MEASURES: Age and sex standardised mortality ratios and multivariable hazard ratios of death after a median of 14 years' follow-up. RESULTS: Patients with osteoarthritis had excess all cause mortality compared with the general population (standardised mortality ratio 1.55, 95% confidence interval 1.41 to 1.70). Excess mortality was observed for all disease specific causes of death but was particularly pronounced for cardiovascular (standardised mortality ratio 1.71, 1.49 to 1.98) and dementia associated mortality (1.99, 1.22 to 3.25). Mortality increased with increasing age (P for trend <0.001), male sex (adjusted hazard ratio 1.59, 1.30 to 1.96), self reported history of diabetes (1.95, 1.31 to 2.90), cancer (2.28, 1.50 to 3.47), cardiovascular disease (1.38, 1.12 to 1.71), and walking disability (1.48, 1.17 to 1.86). However, little evidence existed for increased mortality associated with previous joint replacement, obesity, depression, chronic inflammatory disease, eye disease, or presence of pain at baseline. The more severe the walking disability, the higher was the risk of death (P for trend <0.001). CONCLUSION: Patients with osteoarthritis are at higher risk of death compared with the general population. History of diabetes, cancer, or cardiovascular disease and the presence of walking disability are major risk factors. Management of patients with osteoarthritis and walking disability should focus on effective treatment of cardiovascular risk factors and comorbidities, as well as on increasing physical activity.
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In people with chronic pain, poorer physical function and immobility are linked to higher all-cause and cardiovascular mortality.
“Reduced physical function and consequent lack of mobility in people with chronic pain is associated with increased all-cause and cardiovascular mortality (Nüesch 2011)”
From Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews (2017) · cites this paper as Nüesch 2011
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- Authors
- Nuesch, E., Dieppe, P., Reichenbach, S., Williams, S., Iff, S., & Juni, P.
- Affiliations
- University of Exeter (GB)
- University of Bern (CH)
- University of Bristol (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2011-03-08
- Volume
- 342
- Issue
- mar08 2
- Pages
- d1165-d1165
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC3050438
- OpenAlex
- W2024588402
- Cited by
- 730
- References
- 44
- Citations by year
- 2026: 31 · 2025: 42 · 2024: 36 · 2023: 51 · 2022: 40 · 2021: 60 · 2020: 61 · 2019: 53 · 2018: 48 · 2017: 64 · 2016: 60 · 2015: 57 · 2014: 43 · 2013: 41 · 2012: 27
- FWCI
- 29.02
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- BORIS (University Library Bern) (submittedVersion)
- Figshare (submittedVersion)
- Open Research Exeter (University of Exeter) (submittedVersion)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (66377, 066377, 66378)
- Versus Arthritis
- Medical Research Council
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- knee osteoarthritis, hip osteoarthritis, mortality, all-cause mortality, cardiovascular mortality, dementia mortality, walking disability, diabetes mellitus, cancer, cardiovascular disease, comorbidities, mortality risk factors
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Diabetes Mellitus, England, Epidemiologic Methods, Female, Persons with Disabilities, Humans, Male, Middle Aged, Neoplasms, Social Class, Osteoarthritis, Hip, Walking, Age Distribution, Sex Distribution, Osteoarthritis, Knee
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