Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis

Abstract

The objective of this study is to investigate the association between clinical and laboratory prognostic factors, radiographic severity, and functional limitations in Turkish patients with ankylosing spondylitis (AS). One hundred and two patients with AS were included in this study (66 male patients, 65%). All the necessary information regarding predictor variables, including clinical features, social status, and treatment regimens, were recorded diligently. Their spinal mobility was measured, and then, their disease activities were evaluated by using the Bath Ankylosing Spondylitis Disease Activity Index. Radiological damage (Bath Ankylosing Spondylitis Radiology Index, BASRI) and functional disability (Bath Ankylosing Spondylitis Functional Index, BASFI) were used to evaluate the outcome measures of AS. The male to female ratio was 1.8. Average age at symptom onset was 23.9 ± 28.24 years (6-54 years), and average disease duration was 16.15 ± 10.62 years. Occiput-to-wall distance, hand-to-floor distance, and the modified Schober's test results were worse in males. Hip involvement was more common in male patients, and all radiological measurements were worse in male patients than in the female ones. Disease duration, male sex, and renal stone occurrence were associated with higher radiological score. Erythrocyte sedimentation rate and the disease activity score were associated with high BASFI scores. Higher CRP levels and hip involvement were both associated with high BASRI and BASFI scores. Radiological hip involvement was determined to be an inauspicious predictor for AS (p < 0.0001). We determined a strong association of hip involvement, increased CRP levels, and renal stone history with severe radiographic damage. Hip involvement, disease duration, ESR, CRP levels, and lower socioeconomic status were all associated with a higher BASFI score.

Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

“…Although 9 papers mention the concepts of social events 21,47 , social support 21,42 , social system 21 , social situation 27,30 , effect and consequences 11,21 , social status 15,21,23,28 , social domain and function 31 , and quality of life 21,31 , they are not in relation to social/sex-related causes explaining sex differences in delay in diagnosis. Only Aggarwal in 2009 adequately discussed the complex range of sex factors involved in the diagnostic process of SpA according to sex 8 .…”

“…Delay in diagnosis of SpA has been described in women 5,9,10 and in both sexes 6,7,[11][12][13][14][15][16]20,26,27,29,30,32,33,35,38,39,40,44,45,46 , and although Bandinelli 23 observed less diagnostic delay in women than in men, in most of the papers where delay was compared between men and women, it was greater in women 8,17,18,19,21,22,28,31,34,37,41,42,43,47,48 . This implies that patients have had medically unsolved disorders for a long time, have continued searching for a diagnosis and treatment, or are being erroneously diagnosed and managed 49 .…”

“…Each of these was individually combined with: (delay OR delayed) AND (sex OR gender OR women OR woman) NOT (psoriatic arthritis). Complemen tary papers potentially eligible were included, a search through snowballing was performed by cross reference, and 16 studies were identified 1,3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21] . Ultimately, 379 identified papers were consulted.…”

“…Table 1 shows the main characteristics of the 42 studies on diagnostic delay in SpA included in this systematic review 1,2,3,[8][9][10][11][12][13][14][15][16][17][18]19,20,21,22,23,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]48 . The review included 23,883 patients (67.6% men, 32.3% women).…”

Continuous Improvement of Physical Functioning in Ankylosing Spondylitis Patients by Tumor Necrosis Factor Inhibitors: Three‐Year Followup and Predictors

“…Life-style factors (e.g., smoking, lack of exercise) have also been associated with diminished physical functioning. [3,4,[9][10][11][12][13][14][15] Another potential risk factor for functional decline is the presence of concomitant diseases, such as cardiovascular disease (CVD). There is accumulating evidence that AS patients have a significantly increased CVD risk, due to atherosclerotic disease as well as ASspecific cardiac manifestations.…”