Tzeng Chung-Yuh, Chiang Hsiu-Yin, Huang Chun-Che, Lin Wei-Szu, Hsiao Tzu-Hung, Lin Ching-Heng
Department of Orthopedics, Taichung Veterans General Hospital, Taichung.
Department of Medicinal Botanicals and Health Applications, Da-Yeh University, Changhua.
Medicine (Baltimore). 2019 Sep;98(39):e17204. doi: 10.1097/MD.0000000000017204.
Adhesive capsulitis (AC) is a common chronic disorder for adult patients; however, whether a history of pre-existing shoulder diseases may affect the development of AC is still not fully understood. We aimed to investigate the incidence and prevalence of AC and to assess the association of pre-existing shoulder diseases and traumatic injuries of the shoulder with the development of AC in adults.This retrospective population-based cohort and nested case-control study used data from the National Health Institute Research Database of Taiwan. A total of 24,414 patients aged 20 years or older and with a diagnosis of AC were identified between 2000 and 2013. We calculated the incidence of AC for each year during the study period. In addition, these AC patients were matched with controls (n = 97,656) in a ratio of 1:4 based on age, gender, and index date. Univariate and multivariate logistic regression models were performed to identify variables associated with AC.Females and patients aged 50 to 69 years had higher age-gender standardized incidence and prevalence of AC than their counterparts. Multivariate analyses showed that after adjusting for relevant covariates, pre-existing shoulder diseases of calcific tendinitis (odds ratio [OR] = 8.74, 95% confidence interval [CI] = 5.66-13.5), biceps tendinitis (OR = 7.93, 95% CI = 5.33-11.79), rotator cuff syndrome (OR = 6, 95% CI = 5.26-6.85), osteoarthritis (OR = 4.27, 95% CI = 3.44-5.3), and impingement syndrome (OR = 3.13, 95% CI = 2.64-3.71), as well as fracture (OR = 4.51, 95% CI = 3.82-5.34) and dislocation (OR = 3.57, 95% CI = 2.35-5.45) of the shoulder were significantly associated with AC risk.Higher odds of AC were observed among patients with pre-existing shoulder conditions. This study highlights the need to consider differences in AC risk among patients with various types of shoulder diseases and traumatic injuries of the shoulder.
粘连性肩关节囊炎（AC）是成年患者常见的慢性疾病；然而，既往肩部疾病史是否会影响AC的发生仍未完全明确。我们旨在调查AC的发病率和患病率，并评估既往肩部疾病和肩部创伤与成年人AC发生之间的关联。这项基于人群的回顾性队列研究和巢式病例对照研究使用了台湾国家卫生研究院研究数据库的数据。在2000年至2013年期间，共识别出24414例年龄在20岁及以上且诊断为AC的患者。我们计算了研究期间每年AC的发病率。此外，这些AC患者根据年龄、性别和索引日期以1:4的比例与对照组（n = 97656）进行匹配。进行单因素和多因素逻辑回归模型以识别与AC相关的变量。女性以及年龄在50至69岁的患者，其年龄性别标准化的AC发病率和患病率高于相应的对照人群。多因素分析表明，在调整相关协变量后，既往肩部疾病如钙化性肌腱炎（优势比[OR] = 8.74，95%置信区间[CI] = 5.66 - 13.5）、肱二头肌肌腱炎（OR = 7.93，95% CI = 5.33 - 11.79）、肩袖综合征（OR = 6，95% CI = 5.26 - 6.85）、骨关节炎（OR = 4.27，95% CI = 3.44 - 5.3）和撞击综合征（OR = 3.13，95% CI = 2.64 - 3.71），以及肩部骨折（OR = 4.51，95% CI = 3.82 - 5.34）和脱位（OR = 3.57，95% CI = 2.35 - 5.45）均与AC风险显著相关。在有既往肩部疾病的患者中观察到AC的发生几率更高。本研究强调需要考虑不同类型肩部疾病和肩部创伤患者在AC风险上的差异。
