Tie Kai, Wang Hua, Yang Xu, Ni Qubo, Chen Liaobin
Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuchang District, Wuhan, 430071, China.
Aging Clin Exp Res. 2023 Mar;35(3):615-620. doi: 10.1007/s40520-023-02347-5. Epub 2023 Feb 1.
To explore the risk factors of elderly patients with frozen shoulder.
262 cases of scapulohumeral periarthritis treated in our hospital from January 2020 to December 2020 were analyzed retrospectively. According to the age of patients, patients younger than 60 years old were divided into middle-aged group (101 cases), patients between 60 and 75 years old were divided into old-aged group (91 cases), and patients ≥ 75 years old were divided into old-aged group (70 cases). The general demographic data and clinical data of the three groups were compared. Visual analogue scale (VAS) was used to evaluate the degree of pain. Finally, the dependent variable is set as whether the onset age of scapulohumeral periarthritis patients is advanced. Univariate and multivariate Logistic regression was used to analyze the risk factors of frozen shoulder patients at an advanced age.
There were no significant differences in general demographic data, fixed position, hypertension history, smoking history, drinking history, supraspinatus muscular atrophy and physical exercise among the three groups (all P > 0.05). The course of disease, diabetes, surgical treatment, pain degree, operation time, cholecystitis, coronary heart disease, pain degree three months after operation and cervical spondylosis in the elderly group were all higher than those in the middle-aged group and the elderly group, and the differences were statistically significant (all P < 0.05). The course of scapulohumeral periarthritis, the degree of pain and the degree of pain 3 months after operation in the elderly group were higher than those in the middle-aged group, with significant differences (all P < 0.05). Univariate Logistic regression analysis showed that the risk factors of scapulohumeral periarthritis in the elderly included diabetes mellitus (OR = 3.067, 95% CI 1.881-4.587, P < 0.001), operative treatment (OR = 3.076, 95% CI 1.365-6.765, P = 0.006), VAS score (OR = 2.267, 95% CI 1.117-3.887, P = 0.013), operation time (OR = 1.537, 95% CI 1.305-2.579, P < 0.001), cholecystitis (OR = 2.143, 95% CI 1.019-4.876, P = 0.023), coronary heart disease(OR = 3.128, 95% CI 1.428-7.019, P = 0.005), VAS at 3 months after operation (OR = 1.537, 95% CI 0.786-2.635, P = 0.002), and cervical spondylosis(OR = 1.162, 95% CI 1.029-1.321, P = 0.012). Multivariate logistic regression analysis showed that the risk factors for the onset of the disease at advanced age included fatty infiltration (OR = 4.021, 95% CI 2.981-9.682, P < 0.001), surgical treatment (OR = 4.109, 95% CI 1.419-7.832, P = 0.008), VAS score (OR = 3.081, 95% CI 1.042-7.931, P = 0.046) and operation time (OR = 1.537, 95% CI 1.305-2.579, P < 0.001).
Risk factors of frozen shoulder at advanced age include fat infiltration, surgical treatment, VAS score and surgical time. In clinical practice, we should refer to the above indicators to help patients with early medical intervention and prevent their onset.
探讨老年肩周炎患者的危险因素。
回顾性分析2020年1月至2020年12月在我院治疗的262例肩周炎患者。根据患者年龄,将60岁以下患者分为中年组(101例),60至75岁患者分为老年组(91例),≥75岁患者分为高龄组(70例)。比较三组的一般人口学资料和临床资料。采用视觉模拟评分法(VAS)评估疼痛程度。最后,将因变量设定为肩周炎患者发病年龄是否偏大。采用单因素和多因素Logistic回归分析高龄肩周炎患者的危险因素。
三组在一般人口学资料、固定体位、高血压病史、吸烟史、饮酒史、冈上肌萎缩和体育锻炼方面均无显著差异(均P>0.05)。老年组的病程、糖尿病、手术治疗、疼痛程度、手术时间、胆囊炎、冠心病、术后3个月疼痛程度和颈椎病均高于中年组和老年组,差异有统计学意义(均P<0.05)。老年组肩周炎病程、疼痛程度及术后3个月疼痛程度均高于中年组,差异有统计学意义(均P<0.05)。单因素Logistic回归分析显示,老年肩周炎的危险因素包括糖尿病(OR=3.067,95%CI 1.881-4.587,P<0.001)、手术治疗(OR=3.076,95%CI 1.365-6.765,P=0.006)、VAS评分(OR=2.267,95%CI 1.117-3.887,P=0.013)、手术时间(OR=1.537,95%CI 1.305-2.579,P<0.001)、胆囊炎(OR=2.143,95%CI 1.019-4.876,P=0.023)、冠心病(OR=3.128,95%CI 1.428-7.019,P=0.005)、术后3个月VAS评分(OR=1.537,95%CI 0.786-2.635,P=0.002)和颈椎病(OR=1.162,95%CI 1.029-1.321,P=0.012)。多因素Logistic回归分析显示,高龄发病的危险因素包括脂肪浸润(OR=4.021,95%CI 2.981-9.682,P<0.001)、手术治疗(OR=4.109,95%CI 1.419-7.832,P=0.008)、VAS评分(OR=3.081,95%CI 1.042-7.931,P=0.046)和手术时间(OR=1.537,95%CI 1.305-2.579,P<0.001)。
高龄肩周炎的危险因素包括脂肪浸润、手术治疗、VAS评分和手术时间。在临床实践中,应参考上述指标,帮助患者进行早期医疗干预,预防发病。