Article

OBJECTIVES: To describe the prevalence of musculoskeletal conditions (MSKC) in
patients with coronary artery disease (CAD); to examine the sociodemographic,
clinical, and psychosocial predictors of these comorbidities; and to describe
health care utilization by musculoskeletal comorbidity status. DESIGN: This was a
cross-sectional, observational study in which patients were administered a
questionnaire in the hospital and 1 year later. SETTING: Eleven hospitals in
Ontario, Canada. PARTICIPANTS: CAD patients (N=1803). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Sociodemographic, MSKC, clinical, and
psychosocial factors were ascertained via questionnaire and in-hospital chart
extraction. A health care utilization questionnaire was mailed 1 year later.
RESULTS: Over half (56%) of the patients with CAD had MSKCs, with arthritis/joint
pain accounting for 64.4% of these MSKCs. Patients who were older (odds ratio
[OR]=1.03), women (OR=1.87), white (OR=1.80), with higher body mass index
(OR=1.05), depressive symptoms (OR=1.92), and lower family income (OR=1.46) were
more likely to present with MSKCs. One year posthospitalization, a greater
proportion of those with MSKCs reported >/=1 cardiac-related emergency department
visit (33.2% vs 28.3%, P=.03), hospital admission (30.7% vs 22%, P=.006), more
primary care physician visits (6.6+/-5.6 vs 5.7+/-4.6, P<.001), and fewer cardiac
rehabilitation referrals (61.5% vs 70%, P<.001). After adjusting for depressive
symptoms, body mass index, age, income, ethnicity, and sex, MSKCs predicted only
hospital readmissions. CONCLUSIONS: Over half of the patients hospitalized for
CAD have MSKCs. Those with MSKCs have a physical and psychosocial profile that
places them at greater cardiovascular risk than those with CAD only, explaining,
in part, their greater health care utilization. Despite a greater need for
comprehensive risk factor management in patients with MSKCs, fewer were referred
to cardiac rehabilitation.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS