Zheng Xiaohong, Simpson Julie A, van der Windt Daniëlle A W M, Elliott Alison M
Department of Information Services, King Edward VII Hospital, St. Leonards Road, Windsor, Berks, SL4 3DP, UK.
J Clin Epidemiol. 2005 Aug;58(8):823-30. doi: 10.1016/j.jclinepi.2005.01.011.
Shoulder pain is a common complaint in primary care, and the factors associated with persisting shoulder pain are varied. We therefore explored prognostic factors associated with shoulder pain problems.
Patients (n=109) were randomly allocated to 6 weeks of treatment with either corticosteroid injections (53 patients) or physiotherapy (56 patients). Patients were followed for 52 weeks. Severity of pain and shoulder disability was repeatedly scored at baseline and at 3, 7, 13, 26, and 52 weeks after randomization. Logistic regressions and mixed-effects models were used to explore prognostic factors.
The data showed that during the 52 weeks of follow-up, 22% of the patients had persistent-recurrent symptoms (high risk of disability); the associated prognostic factors were gender (female) and age (>60 years). For the remaining patients, who had steady improvement in pain severity during the 52 weeks, there were still large between-patient variations in the rate of reaching recovery; this was influenced by treatment types: corticosteroid injections were associated with a faster relief of the pain.
Age and gender might be the two important prognostic factors associated with persistent-recurrent problems. The effect of corticosteroid injections seems to be temporal.
肩部疼痛是基层医疗中常见的主诉，与持续性肩部疼痛相关的因素多种多样。因此，我们探讨了与肩部疼痛问题相关的预后因素。
将109例患者随机分为两组，分别接受为期6周的皮质类固醇注射治疗（53例患者）或物理治疗（56例患者）。对患者进行了52周的随访。在基线以及随机分组后的第3、7、13、26和52周，对疼痛严重程度和肩部功能障碍进行多次评分。采用逻辑回归和混合效应模型来探讨预后因素。
数据显示，在52周的随访期间，22%的患者出现持续复发症状（残疾风险高）；相关的预后因素为性别（女性）和年龄（>60岁）。对于其余在52周内疼痛严重程度稳步改善的患者，恢复率在患者之间仍存在很大差异；这受到治疗类型的影响：皮质类固醇注射与疼痛更快缓解相关。
年龄和性别可能是与持续复发问题相关的两个重要预后因素。皮质类固醇注射的效果似乎是暂时的。
