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Clinical Rheumatology

, Volume 28, Issue 9, pp 1083–1089 | Cite as

Effect of comorbidity on quality of life of male veterans with prevalent primary total knee arthroplasty

  • Jasvinder A. Singh
Brief Report

Abstract

This is a study of the impact of specific and overall comorbidity on health-related quality of life (HRQoL) in men with primary total knee arthroplasty (TKA). In a population-based sample of male veterans who responded to a cross-sectional survey using the validated short-form 36 for veterans (SF-36 V) and had undergone primary TKA prior to survey, eight SF-36 V domain and two summary scores (physical and mental component (PCS and MCS) summary) were compared using multivariable-adjusted multiple linear regressions between patients with and without five comorbidities—chronic obstructive pulmonary disease (COPD)/asthma, diabetes, depression, hypertension, and heart disease. Analyses were adjusted for age, five comorbidities, and time since TKA. Two hundred ninety-three male patients constituted the analytic set with mean (SD) age of 70.3 (8.8) years; 97% were Caucasian and mean (SD) duration since TKA was 2.1 (0.7) years. COPD/asthma was associated with significantly lower adjusted MCS (mean ± standard error of mean, 47.1 ± 0.7 vs. 43.1 ± 1.2; p ≤ 0.001) and PCS (30.1 ± 0.6 vs. 27.7 ± 1.0; p < 0.05), depression with significantly lower MCS (48.9 ± 0.7 vs. 37.6 ± 1.2; p ≤ 0.001) but not PCS, hypertension with significantly lower MCS (47.0 ± 0.7 vs. 44.3 ± 1.0; p < 0.05) but not PCS, and heart disease with significantly lower MCS (47.4 ± 0.8 vs. 44.2 ± 0.9; p ≤ 0.001) and PCS (30.5 ± 0.7 vs. 28.1 ± 0.8; p < 0.05). Diabetes was not associated with lower MCS or PCS. The overall number of comorbidities was associated with lower MCS and PCS (p ≤ 0.001 for both). Medical and psychiatric comorbidity impacts physical and mental/emotional HRQoL in patients with primary TKA. The impact differs by comorbidity. Higher comorbidity load negatively impacts both physical and mental/emotional HRQoL.

Keywords

Comorbidity Health-related quality of life HRQoL Knee arthroplasty Quality of life Total knee arthroplasty 

Notes

Acknowledgement

This project was supported by an NIH CTSA Award 1 KL2 RR024151-01 (Mayo Clinic Center for Clinical and Translational Research).

Disclosures

None

Key messages

1. Higher comorbidity is associated with worse physical and mental/emotional HRQoL in primary TKA patients.

2. COPD/asthma and heart disease impact physical and mental/emotional HRQoL in primary TKA patients.

3. Depression and hypertension impact mental/emotional but not physical HRQoL in primary TKA patients.

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Copyright information

© Clinical Rheumatology 2009

Authors and Affiliations

  1. 1.Rheumatology Section, Medicine ServiceMinneapolis VA Medical CenterMinneapolisUSA
  2. 2.Division of Rheumatology, Department of MedicineUniversity of MinnesotaMinneapolisUSA
  3. 3.Departments of Health Sciences and Orthopedic SurgeryMayo Clinic School of MedicineRochesterUSA

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