Background/Purpose: Osteoarthritis/arthrosis is an aging-related disease which is associated with significant morbidity in the United States. However, epidemiological data regarding osteoarthritis-associated mortality in the United States (US) remains scarce. The aim of this study is to determine trends and disparities in osteoarthritis-related mortality in the US between 1999 and 2020.

Methods: A retrospective analysis was conducted using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. The age-adjusted mortality rates (AAMR) and crude death rates per 100,000 persons were determined. The average annual percentage change (AAPC) was calculated through Joinpoint regression analysis. The results were compared to determine temporal trends in sex, race, geographical distribution and patient age-related mortality in osteoarthritis patients.

Results: Between 1999 and 2020, 277,211 deaths occurred in osteoarthritis patients aged 45 years and above. Majority of the patients had died within nursing homes/long-term care facilities (47.38%). The AAMR reduced from 15.5 in 1999 to 6.52 in 2020 with an AAPC of -4.52% (p< 0.0001). Females were disproportionately affected with higher AAMR (12.04) compared to males (8.27), although their AAPCs were nearly similar (-4.36% vs. -4.39%, respectively). Racial differences persisted with non-Hispanic (NH) White having the highest AAMR (11.43) followed by NH Black/African American (9.52), NH American Indian/Alaskan Native (7.53), Hispanic/Latino (5.73) and NH Asian/Pacific Islander (4.24). Between 1999-2020, Hispanic/Latino showed the greater overall decline in osteoarthritis-related mortality (AAPC of -5.16%; p< 0.0001) while American Indian/Alaskan Natives showed the least decline (AAPC of -3.88%; p< 0.0001). Geographically, the Midwest had the highest AAMR (15.36) while the Northeast had the lowest (8.89). The decline in osteoarthritis-related mortality was nearly similar between the various census regions (AAPC: -4.25% to -4.34%). States with the highest AAMRs included Nebraska, Ohio, West Virginia, Vermont, and South Dakota. Residents of non-metropolitan areas showed a higher AAMR (15.47) compared to metropolitan areas (9.73). Age-stratification into 10-year age groups showed a consistent increase in the crude death rate with age (from 0.29 in 45-54 years to 140.58 in those older than 85 years). The decline in osteoarthritis-related mortality between 1999-2020 was seen in all age-groups with the greatest overall decline seen in the 75-84 years age group (AAPC:-4.56%; p< 0.0001) followed closely by the 85+ age group (AAPC:-4.45%; p< 0.0001).

Conclusion: Over the past two decades, osteoarthritis-related mortality in the US has significantly declined, with notable disparities across sex, race, geographic location, and age. Females, non-Hispanic Whites, residents of the Midwest, and those in non-metropolitan areas had higher mortality rates. These findings emphasize the need for targeted interventions to address disparities and further reduce mortality.

Image 1: Osteoarthritis related Age-Adjusted Mortality Rate (AAMR)

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/trends-and-disparities-in-osteoarthritis-related-mortality-in-the-united-states-a-21-year-analysis-1999-2020/