title: Effect of comorbidity on quality of life of male veterans with prevalent primary total knee arthroplasty.
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 <or= 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 <or= 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 <or= 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 <or= 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.
authors.affiliation: Rheumatology Section, Medicine Service, Minneapolis VA Medical Center, Minneapolis, MN 55417, USA. Jasvinder.md@gmail.com
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D015146:Midwestern United States / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D011788:Quality of Life; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000523:psychology*; D014728:Veterans / Q000706:statistics & numerical data*