THE NOSOLOGICAL PATTERN OF DISABILITY IN OSTEOARTHRITIS IN THE IRKUTSK REGION

Abstract

Objective: to investigate the nosological pattern of primary disability due to osteoarthritis (OA) in the Irkutsk Region in 2012–2016, its severity, age- and gender-related features. Material and methods. A continuous method was used to analyze the database on the newly recognized as disabled due to OA in the Irkutsk Region in 2012–2018. The pattern, degree of disability, its age- and gender-related characteristics were studied. Results and discussion. Among those who were the newly recognized as disabled due to OA in 2012–2014, there was the largest proportion of patients with knee OA (46.6 to 52.7%, respectively). There was a preponderance of the disabled due to hip OA in 2015–2016 (55.3% and 65.3%, respectively). Among the OA patients with newly established disability during the analyzed period, there was a preponderance of women, but their proportion in 2016 was smaller than that in 2012 (54.4 and 74.2%, respectively). The decrease was mainly due to women with polyarticular OA (83.5% in 2012; 67.5% in 2016), hip OA (54.3 and 42.0%), or knee OA (87.2 and 80.4%, respectively). Most of the disabled people with OA were pensioners (64.7% for an average of 5 years). Over the past 3 years, the proportion of disabled young people (aged less than 44 years) substantially increased from 7.1% in 2014 to 15.3% in 2016 and that of disabled adult people rose from 21.2% in 2014 to 30.1% in 2016. Among the disabled with hip joint damage, young and adult patients were more and pensioners were fewer than among those with polyarticular OA (16.8 and 3.1%; 31.5 and 23.5%; 51.9 and 73.4% for an average of 5 years, respectively). Knee OA-associated disability was established mainly in pensioners (80.2%), while the proportion of young people was only 2.0%, which was much fewer than in those with hip OA, polyarticular OA, and other variants of the disease (9.2%). The proportion of disabled adult persons was also fewer (18.1% for an average of 5 years). According to the severity of disability due to OA, the largest one was group with class III disability (81.7% in 2012 to 90.9% in 2015). Group with class II disability were much less – from 16.1 to 8.3%, respectively. The minimum number of patients was recognized as having class I disability. The last five years have been marked by an improvement in the pattern of polyarticular OA and osteoarthritis-related primary disability according to its severity, by reducing the proportion of people in the most severe groups with class I and II disability and by increasing the proportion of people having class III disability. The increase in the proportion of people with class II disability due to hip OA to 22.3% in 2016 from 11.4% in 2015 was due to isolated cases of complications after hip replacement.