Clinical Characteristics and Risk Factors of Hyperkyphosis in a Chinese Cohort With Axial Spondyloarthritis: A Multicenter Retrospective Study

Objective This study aimed to investigate the clinical characteristics and risk factors of hyperkyphosis in a Chinese cohort of patients with axial spondyloarthritis (axSpA).

Methods A cross-sectional study was conducted in a group of 607 patients with axSpA attending 12 hospitals across 11 centers from March 2022 to March 2024. Univariate and multivariate logistic regression analyses were used to explore the relevant risk factors of hyperkyphosis. A nomogram model was used for impact factor visualization and Spearman correlation analysis was used to analyze the relationship between the risk factors.

Results Multivariate logistic regression revealed that male sex, disease duration, patient global assessment, erythrocyte sedimentation rate, modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), pharmacological treatment, and Axial Spondyloarthritis Disease Activity Score based on C-reactive protein significantly influenced hyperkyphosis (all P < 0.05). Based on the results of the multivariate logistic regression analysis, we constructed a nomogram model for clinical evaluation with an area under the curve of 0.98 and an accuracy of 0.95. Spearman correlation analysis showed a positive correlation between the Assessment of SpondyloArthritis international Society Health Index (ASAS HI) and mSASSS (ρ 0.16, P < 0.001), whereas pharmacological treatment was negatively correlated with disease activity and mSASSS (ρ −0.24 and −0.18, respectively; P < 0.001).

Conclusion Controlling disease activity in clinical practice is crucial. Active pharmacological treatment should be employed to delay radiological progression and to improve patient ASAS HI scores, psychological well-being, and physical functioning. Additionally, smoking cessation and weight control are recommended to reduce disability.