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تاثيرات الامراض المتزامنة على فاعلية المرض والحالة الوظيفية للمرضى المصابين بالتهاب الفقار المقسط == Comorbidities Effects on Disease Activity and Functional Status in Patients with Ankylosing Spondylitis
Author name:
غسان مكي كاظم
Supervisor name:
نزار عبد اللطيف جاسم
General topic:
Medicine
Specific topic:
Diseases - Joints
Degree:
Higher Diploma
University:
University of Baghdad - Faculty Of Medicine
Language:
English
University location:
Baghdad
First pages:
19T1399 - p.pdf
Abstract:
Ankylosing spondylitis is a chronic, multisystem inflammatory disorder that primarily involving the sacroiliac joints and the axial skeleton and less frequently the peripheral joints, entheses as well as other extra - articular organs such as eyes, skin, and cardiovascular system.Patients with ankylosing spondylitis frequently suffer from comorbidities that may either be linked to the disease process, to the treatment, or may be an independent finding and they contribute to the burden of the disease.Objective : To evaluate the relative frequency of comorbidities in ankylosing spondylitis and their effects on disease activity and functional status. Patients and methods : A longitudinal study was conducted on (402) ankylosing spondylitis patients. Patients who had irregular registration were excluded.Demographic and clinical data were collected including age, sex, duration of disease, previous and current treatment, Bath Ankylosing Spondylitis Disease Activity Index score (BASDAI) and Bath Ankylosing Spondylitis Functional Index score (BASFI) were applied to all patients. All patients were asked to confirm the presence of any of five comorbidities which were hypertension, diabetes mellitus, peptic ulcer, heart failure and cerebrovascular accident, then presence of many of these comorbidities were confirmed by data from patient’s medical reports or physician prescriptions.Results : The most frequently reported comorbidity in the current study sample was hypertension(20.1%), Peptic ulcer is (17.2%), diabetes mellitus is (9.5%), heart failure and cerebrovascularVIaccident were very rare, accounting both for (2%) of all cases. At least one of these comorbidconditions was present in (30.6%) of cases.Presence of hypertension was associated with significant increase in BASDAI and BASFI at baseline. Additionally it was found that presence of any comorbid condition or multiple comorbidities was associated with higher mean BASDAI and BASFI. Presence of the remaining comorbidities had no significant differences.Hypertension is associated with a significantly higher mean reduction in BASDAI score after six months of biological treatment compared to those with no hypertension. Similarly the presence of any comorbid condition or multiple comorbid conditions are associated with significant mean reduction in BASDAI score after six months, The remaining comorbid conditions had no significant association with the mean change in BASDAI score.None of the tested comorbid conditions had an important or statistically significant association with the mean change in BASFI score after six months. Conclusions : Comorbidities are relatively frequent in ankylosing spondylitis and hypertension is the most common comorbid condition. Multiple comorbid conditions or hypertension with ankylosing spondylitis are associated with more active disease and functional impairment.
