Shoulder adhesive capsulitis: epidemiology and predictors of surgery
Shoulder adhesive capsulitis: epidemiology and predictors of surgery
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DOI：
10.1016/j.jse.2018.04.004
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发表时间：
2018-08-01
影响因子：
3
通讯作者：
Li, Xinning
中科院分区：
文献类型：
--
作者：
Kingston, Kiera;Curry, Emily J.;Li, Xinning
背景：粘连性肩关节囊炎的特征是肩关节逐渐丧失运动能力。本研究评估了与无粘连性胶囊炎的性别匹配对照组相比，与发生粘连性胶囊炎显著相关的患者变量。我们也试图确定那些与粘连性囊炎患者需要手术干预相关的因素。方法：对2004 ~ 2014年在我院就诊的所有粘连性囊炎患者进行分析。收集人口统计学特征，并从电子病历中随机抽取性别匹配的对照组进行比较。此外，还发现了因粘连性囊炎而接受手术干预的患者，并通过logistic回归分析确定了与手术干预相关的因素。结果：纳入黏附性囊炎患者2190例，年龄分布为56.4±13.1岁。大多数被归类为超重（30.7%）或肥胖（27.0%）。与对照组相比，粘连性胶囊炎患者更可能是年轻人（0 vs. bb0 = 50岁；比值比[OR]， 0.69; P < .001）、肥胖（OR, 1.26; P < .001）、黑人/非裔美国人（OR, 1.71; P < .001）、西班牙裔/拉丁裔（OR, 4.85; P < .001）或糖尿病（OR, 1.12; P < .001），而高血压的可能性更小（OR, 0.93； P= .006）。总体而言，361人随后接受了手术干预。老年患者、少数族裔和政府资助/未参保患者因粘连性囊炎接受手术的可能性显著降低（P < 0.01），而工伤赔偿患者接受手术的可能性是私人参保患者的8倍（P < 0.001）。结论：肥胖和糖尿病与粘连性囊炎显著相关，应被视为可改变的患者因素。此外。年轻患者和少数民族也明显更容易被诊断为粘连性囊炎。更年轻。白色。工伤赔偿患者更有可能接受手术。而政府资助或没有保险的患者更有可能接受非手术治疗。(C) 2018年《肩关节外科杂志》理事会理事。版权所有。
Background: Adhesive capsulitis is characterized by a gradual, painful loss of shoulder motion. This study evaluated patient variables significantly associated with developing adhesive capsulitis compared with a sex-matched control group without adhesive capsulitis. We also sought to determine those factors associated with adhesive capsulitis patients requiring surgical intervention.Methods: All patients presenting to our hospital with adhesive capsulitis between 2004 and 2014 were identified. Demographic characteristics were collected, and a sex-matched control group was randomly generated from the electronic medical record and used for comparison. Patients who underwent surgical intervention for adhesive capsulitis were also identified, and factors associated with surgical intervention were identified with logistic regression analysis.Results: Included were 2190 adhesive capsulitis patients with a normal age distribution of 56.4 +/- 13.1 years. Most were classified as overweight (30.7%) or obese (27.0%). Compared with controls, adhesive capsulitis patients were more likely to be younger (0 vs. >= 50 years; odds ratio [OR], 0.69; P < .001), obese (OR, 1.26; P < .001), black/African American (OR, 1.71; P < .001), Hispanic/Latino (OR, 4.85; P < .001), or diabetic (OR, 1.12; P < .001) and less likely to have hypertension (OR, 0.93; P= .006). Overall, 361 subsequently underwent surgical intervention. Older patients, racial minorities, and government-sponsored/uninsured patients were significantly less likely to have surgery for adhesive capsulitis (P < .01), whereas workers' compensation patients were 8 times more likely to receive surgery compared with privately insured patients (P < .001).Conclusions: Obesity and diabetes were significantly associated with adhesive capsulitis and should be considered modifiable patient factors. Additionally. younger patients and racial minorities were also significantly more likely to be diagnosed with adhesive capsulitis. Younger. white. and workers' compensation patients were more likely to receive surgery. whereas patients with government-sponsored or no insurance status were more likely to receive nonoperative treatment. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.