Abstract

Background:Frailty is defined as syndrome of physical decline in late life, characterized by marked vulnerability to adverse health outcomes. Knee osteoarthritis (OA) could be one of the major diseases related to frailty conditions. The prevalence and clinical features of frailty syndrome in knee OA and rheumatoid arthritis (RA) were not reported previously.Objectives:We studied the clinical features and nutritional status of knee OA and RA patients with frailty syndrome in nationwide survey data.Methods:Symptomatic knee osteoarthritis patients were defined who had knee joint pain accompanied with grade 2 or more Kellgren-Lawrence score in plain radiographic studies from the data of KNHANES (N=17,873, from 2010 to 2013). RA was defined who diagnosed by physician. We calculated the frailty index (score 0~1.0) using 46 items from the frailty related co-morbidities and laboratory abnormalities according to Rockwood clinical frailty scale. We analyzed the clinical features of three frailty groups [robust (≤0.10), pre-frail (0.1< * ≤0.21), and frail (>0.21)] in symptomatic radiographic knee OA patients and RA patients.Results:The prevalence of Knee OA patients was 8.59% [95% CI: 8.19-9.01]. Relative risk ratio is significantly increased in pre-frail (OA; 2.66 [2.26-3.14], RA;4.02 [3.07-5.27]) and frail group (OA; 6.27 [5.20-7.57], RA;7.00[5.03-9.74]) in polytomous logistic regression.Body mass index (BMI), white blood cell, platelet, and serum creatinine were significantly increased in knee OA and RA patients with frailty syndrome. But, hemoglobin, estimated GFR (CKD-EPI equation) and EQ-5D were significantly decreased in knee OA and RA patients with frailty syndrome (Table). The daily nutritional intakes of total calories, carbohydrate, protein, fat, sodium and potassium were significantly decreased in knee OA patients with the frailty syndrome. In RA patients, the significant decreased nutritional intakes of total calories, carbohydrate, protein and fat were observed.Conclusion:We showed increased BMI, decreased renal function and lower nutritional status in symptomatic radiographic knee OA and RA patients with frailty syndrome.Table.RobustPre-frailFrailpBody mass index (kg/m2)Knee OA24.13 [23.74-24.53]25.07 [24.83-25.32]25.46 [25.14-25.78]< 0.0001RA23.73[23.04-24.42]23.58 [23.20-23.97]24.97 [24.28-25.66]0.001Hemoglobin, g/dLKnee OA13.53 [13.36-13.70]13.51 [13.42-13.61]13.27 [13.14-13.40]0.004RA13.63 [13.34-13.9213.30 [13.14-13.46]13.15 [12.85-13.45]0.060White blood cell, 103/μLKnee OA5.50 [5.29-5.71]5.94 [5.81-6.07]6.41 [6.24-6.58]< 0.0001RA5.47 [5.13-5.82]5.85 [5.64-6.06]6.68 [6.32-7.03]< 0.0001Platelet, 103/μLKnee OA246.03 [238.52-253.53]258.13 [253.44-262.82]259.96 [253.40-266.53]0.045RA237.49 [222.91-252.06]255.30 [247.50-263.10]262.04 [248.32-275.77]0.038Serum creatinine, mg/dLKnee OA0.734 [0.712-0.756]0.764 [0.751-0.777]0.861 [0.826-0.895]< 0.0001RA0.732 [0.686-0.779]0.783 [0.762-0.805]0.917 [0.840-0.994]< 0.0001CKD-EPI eGFR, ml/minKnee OA88.54 [86.77-90.31]83.89 [82.89-84.88]76.22 [74.80-77.63]< 0.0001RA94.30 [90.77-97.82]85.86 [84.00-87.73]74.76 [70.91-78.61]< 0.0001EQ-5DKnee OA0.933 [0.921-0.944]0.804 [0.793-0.815]0.635 [0.616-0.653]< 0.0001RA0.966 [0.953-0.979]0.857 [0.839-0.874]0.666 [0.619 -0.713]< 0.0001Acknowledgments:NoneDisclosure of Interests:None declared

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