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Vol. 17. Issue 8.
Pages 440-446 (October 2021)
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Vol. 17. Issue 8.
Pages 440-446 (October 2021)
Original Article
DOI: 10.1016/j.reumae.2020.03.004
Comorbidity burden in terms of disability in patients with osteoarthritis in Mexico. The IMPACTAR registry
Carga de comorbilidad en términos de discapacidad en pacientes con osteoartritis en México. El registro IMPACTAR
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David Vega-Moralesa,b, Jorge Antonio Esquivel-Valerioa, Brenda Roxana Vázquez-Fuentesa, Alejandro Díaz-Borjónc, César Alejandro Arce-Salinasd, Everardo Álvarez-Hernándeze, José Fernando Torres-Roldánf, José Manuel Aguilera-Zepedag, Víctor Toledo-Infansonh, Ernesto Alcántar-Lunai, Jorge Antonio Aldrete-Velascoj, José Luis Martínez Hernándezk, Jaime José Gutiérrez-Gómezl, Rolando Espinosa-Moralesm,
Corresponding author
rolespi@yahoo.com

Corresponding author.
, for the collaborative IMPACTAR study group
a Universidad Autónoma de Nuevo León, Rheumatology Service and Internal Medicine Department at Hospital Universitario “Dr. José Eleuterio González”, Ave. Gonzalitos 235 Norte, Colonia Mitras Centro, Monterrey, C.P. 64020 Nuevo León, Mexico
b Instituto Mexicano del Seguro Social, IMSS Hospital General de Zona Número 17, Fortunato Lozano 2627, Benito Juárez, Monterrey, C.P. 64420 Nuevo León, Mexico
c Hospital Angeles Lomas, Av. Vialidad de la Barranca S/N. Col. Valle de las Palmas, C.P. 52763 Mexico City, Mexico
d Hospital Central Sur PEMEX, Division of Internal Medicine, Fuentes del Pedregal, Tlalpan, C.P. 14140 Mexico City, Mexico
e Hospital General de Mexico, Doctor Balmis 148, Doctores, Delegación Cuahutemoc, C.P. 06726 Mexico City, Mexico
f Hospital Star Medica, San Luis Potosí 143, Roma Nte., C.P. 06700 Mexico City, Mexico
g Hospital Médica Sur; Puente de Piedra 150, Pueblo Quieto, Tlalpan, C.P. 14050 Mexico City, Mexico
h Hospital General Agua Prieta, Servicios de Salud Sonora, Calle 12 y 13 Av 22S/NInt. 3, Agua Prieta, C.P. 84200 Sonora, Mexico
i Hospital Angeles del Carmen, Fracc. Monraz, Monraz, Guadalajara, C.P. 44670 Jalisco, Mexico
j Hospital Español de la Ciudad de México, Ejercito Nacional # 613, Granada, C.P. 11520 Mexico City, Mexico
k Hospital Angeles del Pedregal, Camino de Sta, Teresa 1055, Héroes de Padierna, C.P. 10700 Mexico City, Mexico
l Private Practice, Av. 4a. Nte. Pte. 836, Guadalupe, Tuxtla Gutierrez, C.P. 29000 Chiapas, Mexico
m Instituto Nacional de Rehabilitación, Departamento de Reumatología, Calz México-Xochimilco 289, Arenal Tepepan, C.P. 14389 Mexico City, Mexico
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Tables (3)
Table 1. Sociodemographic, economic and geographic characteristics associated with disability in patients with OA in Mexico 2013–2015.
Table 2. Clinical characteristics, pharmacologic treatment, and healthcare institution associated with disability in patients with OA in Mexico 2013–2015.
Table 3. Factors associated with the presence of disability in patients with OA in Mexico, 2013–2015.
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Additional material (1)
Abstract
Objective

To determine the comorbidities associated with disability in patients with OA in Mexico (2013–2015).

Material and methods

A cross-sectional, retrospective and multicentre IMPACTAR study (n=7703) in Mexican patients (2013–2015). Comorbidities associated with disability were identified in 4971 patients diagnosed with OA from the IMPACTAR registry (n=7073). An adjusted logistic regression analysis was carried out by demographic, economic, clinical and medical variables.

Results

Mean age was 63 years; and 75% of the patients were women. Subjects with OA and presence of comorbidities are 42% more likely to develop disabilities than patients without associated comorbidity, considering age, sex, family income, OA diagnosis duration, and education level. The highest rate of people with disability (28.9%) was concentrated in Region 7, which corresponds to Mexico City. There are also significant differences between median family incomes, when the income of persons with disability is under $13 000 (IQR: 9000–16 000) Mexican pesos, compared to patients without disability. Almost half of the subjects (49.6%) reported having at least one comorbidity. Arterial hypertension was the risk factor with a statistically significant difference (32.8%) among those with disability (34.7%).

Conclusions

Programs and interventions for OA patients should take into consideration comorbidity factors, being female, family income, and the region of residence as variables that may increase the possibility of developing an OA-associated disability.

Keywords:
Osteoarthritis
Disability
Comorbidity
Arthritis
Chronic disease
Resumen
Objetivo

Determinar las comorbilidades asociadas a la incapacidad en pacientes con osteoartritis (OA) en México (2013-2015).

Material y métodos

Estudio IMPACTAR transversal, retrospectivo y multicéntrico (n=7.703) en pacientes mejicanos (2013-2015). Se identificaron las comorbilidades asociadas a la incapacidad en 4.971 pacientes diagnosticados de OA en el registro IMPACTAR (n=7.073). Se realizó un análisis de regresión logística ajustada por variables demográfica, económica, clínica y médica.

Resultados

La edad media fue de 63 años, y el 75% de los pacientes eran mujeres. Los sujetos con OA y la presencia de comorbilidades tienen un 42% mayor de probabilidad de desarrollar incapacidades que los pacientes sin comorbilidad asociada, considerando la edad, el sexo familia, los ingresos, la duración del diagnóstico de OA y el nivel educativo. La tasa poblacional con mayor tasa de incapacidad (28,9%) se concentró en la Región 7, que corresponde a Ciudad de México. También existieron diferencias significativas entre los ingresos familiares medios, cuando la renta de las personas con incapacidad se sitúa por debajo de los 13.000$ (RIC: 9.000-16.000) pesos mejicanos, en comparación con los pacientes sin incapacidad. Casi la mitad de los sujetos (49,6%) reportaron tener al menos una comorbilidad. La hipertensión arterial fue el factor de riesgo con diferencia estadísticamente significativa (32,8%) entre aquellas personas con incapacidad (34,7%).

Conclusiones

Los programas e intervenciones para pacientes con OA deberían considerar los factores de comorbilidad tales como sexo femenino, ingresos familiares y región de residencia como variables que podrían incrementar la posibilidad de desarrollar una incapacidad asociada a OA.

Palabras clave:
Osteoartritis
Incapacidad
Comorbilidad
Artritis
Enfermedad crónica

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