Risk factors for surgery due to rotator cuff disease in a population-based cohort.
Risk factors for surgery due to rotator cuff disease in a population-based cohort.
复制标题
DOI：
10.1302/0301-620x.102b3.bjj-2019-0875.r1
复制
发表时间：
2020-03
期刊：
影响因子：
--
通讯作者：
Keener JD
中科院分区：
文献类型：
--
作者：
Yanik EL;Colditz GA;Wright RW;Saccone NL;Evanoff BA;Jain NB;Dale AM;Keener JD
旋袖病（RCD）的一些危险因素和相应的治疗已经确定。本研究在一个大队列中评估了许多危险因素与RCD手术事件之间的关系。对英国40-69岁人群（英国生物银行）进行了研究。RCD手术病例通过与研究入组后平均8年的全国医院住院记录的联系来确定。使用多变量Cox比例风险回归来计算风险比（hr），作为考虑混杂因素的RCD手术的关联估计。考虑的危险因素包括年龄、性别、种族、教育、汤森剥夺指数、体重指数（BMI）、职业需求和吸烟暴露。在421,894人中，47%是男性。入组时平均年龄为56岁。共发现2156例RCD手术病例。年龄每增加10岁，RCD手术增加55% （95%CI= 46%-64%）。男性、非白种人、较低的区域剥夺和较高的BMI与RCD手术风险升高有显著相关（均P≤0.01）。较高的职业体力需求与较高的RCD手术率相关（总是、通常和有时从事繁重体力劳动与从不进行体力劳动的hr =2.1、1.8和1.4）。戒烟者的RCD手术率高于从不吸烟者（HR=1.23[95%CI= 1.12-1.35]），而目前吸烟者的RCD手术率与从不吸烟者相似（HR=0.94[95%CI= 0.80-1.11]）。在从不吸烟的人群中，家庭成员中有100人吸烟的RCD手术风险更高（HR=1.78[95%CI= 1.08-2.92]），但其他二手烟措施无显著性差异。许多因素与RCD手术独立相关，包括年龄较大、男性、较高的BMI、较低的面积剥夺和较高的职业体力要求。一些已确定的风险因素是可以改变的，这表明RCD的医疗负担可以通过追求公共卫生目标（如减少肥胖和改变职业需求）来减轻。
Few risk factors for rotator cuff disease (RCD) and corresponding treatment have been firmly established. This study evaluates the relationship between numerous risk factors and incident RCD surgery in a large cohort. A population-based cohort of people aged 40–69 in the United Kingdom (the UK Biobank) was studied. RCD surgery cases were identified through a linkage with national hospital inpatient records covering a mean of 8 years after study enrollment. Multivariable Cox proportional hazards regression was used to calculate hazard ratios (HRs) as estimates of associations with RCD surgery accounting for confounders. Considered risk factors included age, sex, race, education, Townsend Deprivation Index, body mass index (BMI), occupational demands, and smoking exposures. Of the 421,894 people included, 47% were men. Mean age at enrollment was 56. In total, 2156 incident RCD surgery cases were identified. Each decade increase in age was associated with a 55% increase in RCD surgery (95%CI=46%–64%). Male sex, non-white race, lower area deprivation, and higher BMI were significantly associated with higher RCD surgery risk (all P≤0.01). Greater occupational physical demands were associated with higher RCD surgery rates (HRs=2.1, 1.8, and 1.4 for always, usually, and sometimes doing heavy physical work vs. never). Former smokers had higher RCD surgery rates than never smokers (HR=1.23[95%CI=1.12–1.35]), while current smokers had similar rates as never smokers (HR=0.94[95%CI=0.80–1.11]). Among never smokers, RCD surgery risk was higher among those with >1 household member who smoked (HR=1.78[95%CI=1.08–2.92]), but other secondhand smoke measures were not significant. Numerous factors were independently associated with RCD surgery, including older age, male sex, higher BMI, lower area deprivation, and higher occupational physical demands. Several identified risk factors are modifiable suggesting that the healthcare burden of RCD might be reduced through the pursuit of public health goals such as reducing obesity and modifying occupational demands.