AB0866 THE PREVALENCE AND CLINICAL FEATURES OF FRAILTY SYNDROME IN PATIENTS WITH SYMPTOMATIC RADIOGRAPHIC KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS: A STUDY OF THE KOREAN NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (KNHANES)
Authors: S. H. Joo, J. Lee, Y. W. Song
Journal: Annals of the Rheumatic Diseases (2020)

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&lt; * ≤0.21), and frail (&gt;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. Robust Pre-frail Frail p Body mass index (kg/m 2 ) Knee OA 24.13 [23.74-24.53] 25.07 [24.83-25.32] 25.46 [25.14-25.78] &lt; 0.0001 RA 23.73[23.04-24.42] 23.58 [23.20-23.97] 24.97 [24.28-25.66] 0.001 Hemoglobin, g/dL Knee OA 13.53 [13.36-13.70] 13.51 [13.42-13.61] 13.27 [13.14-13.40] 0.004 RA 13.63 [13.34-13.92 13.30 [13.14-13.46] 13.15 [12.85-13.45] 0.060 White blood cell, 10 3 /μL Knee OA 5.50 [5.29-5.71] 5.94 [5.81-6.07] 6.41 [6.24-6.58] &lt; 0.0001 RA 5.47 [5.13-5.82] 5.85 [5.64-6.06] 6.68 [6.32-7.03] &lt; 0.0001 Platelet, 10 3 /μL Knee OA 246.03 [238.52-253.53] 258.13 [253.44-262.82] 259.96 [253.40-266.53] 0.045 RA 237.49 [222.91-252.06] 255.30 [247.50-263.10] 262.04 [248.32-275.77] 0.038 Serum creatinine, mg/dL Knee OA 0.734 [0.712-0.756] 0.764 [0.751-0.777] 0.861 [0.826-0.895] &lt; 0.0001 RA 0.732 [0.686-0.779] 0.783 [0.762-0.805] 0.917 [0.840-0.994] &lt; 0.0001 CKD-EPI eGFR, ml/min Knee OA 88.54 [86.77-90.31] 83.89 [82.89-84.88] 76.22 [74.80-77.63] &lt; 0.0001 RA 94.30 [90.77-97.82] 85.86 [84.00-87.73] 74.76 [70.91-78.61] &lt; 0.0001 EQ-5D Knee OA 0.933 [0.921-0.944] 0.804 [0.793-0.815] 0.635 [0.616-0.653] &lt; 0.0001 RA 0.966 [0.953-0.979] 0.857 [0.839-0.874] 0.666 [0.619 -0.713] &lt; 0.0001 Acknowledgments: None Disclosure of Interests: None declared