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上肢疾病在骨关节炎患者中的风险:一项倾向评分匹配队列研究。

Risk of Upper Limb Diseases in Osteoarthritis Patients: A Propensity-score-matched Cohort Study.

机构信息

Orthopedics Department, Chi-Mei Medical Center, Tainan, Taiwan, R.O.C.

Orthopedics Department, Chi-Mei Medical Center, Tainan, Taiwan, R.O.C.;

出版信息

In Vivo. 2024 Sep-Oct;38(5):2464-2470. doi: 10.21873/invivo.13716.

Abstract

BACKGROUND/AIM: Osteoarthritis (OA) is a prevalent degenerative joint disease that significantly impacts quality of life, particularly when affecting the hands. However, whether patients with OA are associated with higher risk of developing upper limb disorders, specifically trigger finger (TF) and carpal tunnel syndrome (CTS), remains unclear. This study aimed to evaluate the risk of upper limb disease in OA patients.

PATIENTS AND METHODS

Using the US Collaborative Network, a subset of the TriNetX research network, we identified patients diagnosed with OA and matched them 1:1 with non-OA controls based on propensity scores. Matching covariates included age, sex, race, and comorbidities. The cohort consisted of 1,554,182 patients in each group. The hazard ratio of TF and CTS, as well as related surgical interventions, was assessed over a 5-year follow-up period.

RESULTS

Patients with OA had a 1.30-fold increased risk of TF [95% confidence interval (CI)=1.27-1.33] and a 1.50-fold increased risk of CTS (95%CI=1.48-1.53) compared to controls. The hazard ratios for undergoing surgical interventions were 1.61 for TF (95%CI=1.51-1.71) and 1.97 for CTS (95%CI=1.78-2.19). These risks remained significant across various sensitivity analyses and stratifications according to age and sex.

CONCLUSION

OA significantly increases the risk of TF and CTS. These findings highlight the need for vigilant monitoring and management of upper limb disorders in OA patients to improve overall patient care and outcomes. Future research is warranted to focus on pathological mechanisms of OA and their impact on upper limb health to develop targeted interventions.

摘要

背景/目的:骨关节炎(OA)是一种常见的退行性关节疾病,严重影响生活质量,尤其是手部受累时。然而,OA 患者是否有更高的风险患上上肢疾病,特别是扳机指(TF)和腕管综合征(CTS),目前尚不清楚。本研究旨在评估 OA 患者发生上肢疾病的风险。

患者和方法

我们利用美国协作网络(TriNetX 研究网络的一个子集),根据倾向评分在 OA 患者中匹配了 1:1 的非 OA 对照。匹配的协变量包括年龄、性别、种族和合并症。两组各有 1554182 例患者。在 5 年的随访期间,评估了 TF 和 CTS 的风险比(HR)以及相关手术干预。

结果

与对照组相比,OA 患者 TF 的风险增加了 1.30 倍(95%置信区间[CI]:1.27-1.33),CTS 的风险增加了 1.50 倍(95%CI:1.48-1.53)。TF 手术干预的 HR 为 1.61(95%CI:1.51-1.71),CTS 为 1.97(95%CI:1.78-2.19)。这些风险在各种敏感性分析和根据年龄和性别进行的分层分析中仍然显著。

结论

OA 显著增加了 TF 和 CTS 的风险。这些发现强调了在 OA 患者中需要密切监测和管理上肢疾病,以改善整体患者护理和结局。未来的研究需要关注 OA 的病理机制及其对上肢健康的影响,以开发有针对性的干预措施。

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