Hip symptoms are associated with premature mortality: the Johnston County Osteoarthritis Project.

To investigate the impact of hip osteoarthritis (OA) and/or hip symptoms on excess mortality. We analyzed data from 3,919 individuals in a community-based prospective cohort of African Americans and Caucasians age ≥45 years. Women ≥ 50 years of age and all men underwent supine anteroposterior pelvic radiography at baseline, with the participant’s feet in 15 degrees of internal rotation. Hip radiographic (rOA) was defined as a Kellgren-Lawrence grade of >2 in at least one hip. Participants completed questionnaires at baseline to determine presence of hip symptoms and covariate status. Participants with symptomatic hip rOA (SxOA) are a subset of individuals with hip rOA and symptoms in the same hip. Multiple imputation was used to impute missing values of covariates. Mortality was determined through 2015 and follow-up time was calculated from baseline assessment until death or censoring which took place when a participant was lost to follow-up or reached the end of study period. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals. We carried out additional analyses stratified by sex, race, age and obesity. Mean follow-up time was 14.2 years during which 1762 deaths occurred. There were 29.9% participants in our population with hip rOA at baseline. Compared to those with neither hip rOA nor hip symptoms, we observed an increased risk of all-cause mortality in participants with hip symptoms alone (HR=1.28, 95% 0=1.13-1.46), but no association for hip rOA either with or without symptoms. In stratified analyses we observed increased associations for hip symptoms alone and hip sxOA in those <65 years (43% and 39% increase, respectively) and in Caucasians (34% and 21% increase, respectively). Individuals who had hip symptoms without hip rOA had an increased risk of mortality. These effects were particularly strong for those who were <65 years of age and Caucasians. Effective interventions to identify those with hip pain in order to lessen it could reduce premature mortality.

探讨髋骨关节炎（OA）和/或髋部症状对过高死亡率的影响。 我们分析了来自一个以社区为基础的前瞻性队列中3919名年龄≥45岁的非裔美国人和高加索人的数据。年龄≥50岁的女性和所有男性在基线时接受仰卧位骨盆前后位X线摄影，参与者的双脚呈15度内旋。髋部X线影像（rOA）定义为至少一侧髋部的凯尔格伦 - 劳伦斯分级＞2。参与者在基线时完成问卷调查以确定是否存在髋部症状以及协变量状态。有症状的髋部rOA（SxOA）参与者是髋部rOA且同一髋部有症状的个体的一个子集。采用多重填补法填补协变量的缺失值。死亡率确定至2015年，随访时间从基线评估计算至死亡或失访（当参与者失去随访或达到研究期末时发生）。使用考克斯比例风险回归估计风险比和95%置信区间。我们按性别、种族、年龄和肥胖进行了额外的分层分析。 平均随访时间为14.2年，在此期间发生了1762例死亡。在我们的人群中，基线时有29.9%的参与者患有髋部rOA。与既无髋部rOA也无髋部症状的参与者相比，我们观察到仅有髋部症状的参与者全因死亡风险增加（风险比 = 1.28，95%置信区间 = 1.13 - 1.46），但无论有无症状，髋部rOA均无相关性。在分层分析中，我们观察到在＜65岁的人群中（分别增加43%和39%）以及在高加索人中（分别增加34%和21%），仅有髋部症状和髋部SxOA的相关性增加。 有髋部症状但无髋部rOA的个体死亡风险增加。这些影响在＜65岁的人群和高加索人中尤为显著。采取有效的干预措施来识别髋部疼痛患者以减轻疼痛，可能会降低过早死亡率。