Abstract：
OBJECTIVE: The aim of this study was to determine the success rate, duration of disease control, and predictive factors of success of repeated corticosteroid injections for recurrent trigger finger.
METHODS: This prospective cohort study involved patients who had recurrent trigger finger and a history of corticosteroid injections. A total 114 patients were treated with repeated corticosteroid injections and followed for 12 months. Data on demographic characteristics, comorbid conditions, and possible predictive factors for successful treatment from medical chart reviews and direct patient interviews were compared. Patients were classified into success or failure groups at one, three, six, and 12 months after the initial injection. The relationship between hypothesized predictors and success or failure after repeated corticosteroid injection was analyzed with multivariable logistic regression.
RESULTS: The overall success rates from repeated cortisone injections after one, three, six, and 12 months were 97.4%, 84.2%, 68.4%, and 49.1%, respectively. Multivariable logistic regression modeling revealed that a high grade of disease (grade III or IV based on the Quinnell system), a body mass index (BMI) ≥ 25 kg/m2, and a short symptom-free period (< six months) after a previous injection were strong predictors of symptom recurrence (odds ratio = 3.6 [95% CI 1.5-8.4], odds ratio = 2.5 [95% CI 1.1-5.9], and odds ratio = 1.8 [95% CI 1.1-3.0], respectively). The average success rates for patients at 1-year according to the number of risk factors were as follows: none of the three risk factors, 73.3%; one risk factor, 54.2% to 63.6% (54.2% for grade III-IV triggering, 63.6% for BMI ≥ 25 kg/m2 and 63.6% for < 6-month symptom-free period); two risk factors, 30% to 75% (30% for a combination of grade III-IV and BMI ≥ 25 kg/m2, 45.5% with grade II-IV and < 6-month period, and 75% with a combination of < 6-month period and BMI ≥ 25 kg/m2); and all three risk factors, 11.8%.
CONCLUSIONS: Repeated corticosteroid injections for recurrent trigger finger should be considered in patients who prefer nonsurgical treatment, especially in those without factors predictive of failure.
METHODS: Prognostic II.
METHODS: This prospective cohort study involved patients who had recurrent trigger finger and a history of corticosteroid injections. A total 114 patients were treated with repeated corticosteroid injections and followed for 12 months. Data on demographic characteristics, comorbid conditions, and possible predictive factors for successful treatment from medical chart reviews and direct patient interviews were compared. Patients were classified into success or failure groups at one, three, six, and 12 months after the initial injection. The relationship between hypothesized predictors and success or failure after repeated corticosteroid injection was analyzed with multivariable logistic regression.
RESULTS: The overall success rates from repeated cortisone injections after one, three, six, and 12 months were 97.4%, 84.2%, 68.4%, and 49.1%, respectively. Multivariable logistic regression modeling revealed that a high grade of disease (grade III or IV based on the Quinnell system), a body mass index (BMI) ≥ 25 kg/m2, and a short symptom-free period (< six months) after a previous injection were strong predictors of symptom recurrence (odds ratio = 3.6 [95% CI 1.5-8.4], odds ratio = 2.5 [95% CI 1.1-5.9], and odds ratio = 1.8 [95% CI 1.1-3.0], respectively). The average success rates for patients at 1-year according to the number of risk factors were as follows: none of the three risk factors, 73.3%; one risk factor, 54.2% to 63.6% (54.2% for grade III-IV triggering, 63.6% for BMI ≥ 25 kg/m2 and 63.6% for < 6-month symptom-free period); two risk factors, 30% to 75% (30% for a combination of grade III-IV and BMI ≥ 25 kg/m2, 45.5% with grade II-IV and < 6-month period, and 75% with a combination of < 6-month period and BMI ≥ 25 kg/m2); and all three risk factors, 11.8%.
CONCLUSIONS: Repeated corticosteroid injections for recurrent trigger finger should be considered in patients who prefer nonsurgical treatment, especially in those without factors predictive of failure.
METHODS: Prognostic II.
摘要：
目的：本研究的目的是确定成功率，疾病控制的持续时间，以及反复扳机指反复注射皮质类固醇成功的预测因素。
方法：这项前瞻性队列研究涉及有反复触发指和皮质类固醇注射史的患者。总共114名患者接受了反复的皮质类固醇注射治疗，并随访了12个月。关于人口特征的数据，合并症条件，并比较了从病历回顾和患者直接访谈中获得成功治疗的可能预测因素。患者分为成功或失败组，三,六,在初次注射后12个月。采用多变量logistic回归分析假设预测因子与重复注射皮质类固醇后成功或失败之间的关系。
结果：重复注射可的松后的总体成功率，三,六,12个月为97.4%，84.2%,68.4%,和49.1%，分别。多变量逻辑回归模型显示，高等级疾病(基于Quinnell系统的III级或IV级)，体重指数（BMI）≥25kg/m2，以及先前注射后的无症状期短（<6个月）是症状复发的强预测因子（比值比=3.6[95％CI1.5-8.4]，比值比=2.5[95%CI1.1-5.9]，比值比=1.8[95%CI1.1-3.0]，分别)。根据危险因素的数量，患者1年的平均成功率如下：三个危险因素中没有一个，73.3%；一个危险因素，54.2%至63.6%(III-IV级触发为54.2%，BMI≥25kg/m2为63.6％，<6个月无症状期为63.6％）；两个危险因素，30％至75％（III-IV级和BMI≥25kg/m2的组合为30％，II-IV级和<6个月期间为45.5％，和75％，其中<6个月期和BMI≥25kg/m2）；以及所有三个危险因素，11.8%。
结论：对于喜欢非手术治疗的患者，应考虑反复注射皮质类固醇激素治疗，尤其是那些没有预测失败因素的人。
方法：预后II.
方法：这项前瞻性队列研究涉及有反复触发指和皮质类固醇注射史的患者。总共114名患者接受了反复的皮质类固醇注射治疗，并随访了12个月。关于人口特征的数据，合并症条件，并比较了从病历回顾和患者直接访谈中获得成功治疗的可能预测因素。患者分为成功或失败组，三,六,在初次注射后12个月。采用多变量logistic回归分析假设预测因子与重复注射皮质类固醇后成功或失败之间的关系。
结果：重复注射可的松后的总体成功率，三,六,12个月为97.4%，84.2%,68.4%,和49.1%，分别。多变量逻辑回归模型显示，高等级疾病(基于Quinnell系统的III级或IV级)，体重指数（BMI）≥25kg/m2，以及先前注射后的无症状期短（<6个月）是症状复发的强预测因子（比值比=3.6[95％CI1.5-8.4]，比值比=2.5[95%CI1.1-5.9]，比值比=1.8[95%CI1.1-3.0]，分别)。根据危险因素的数量，患者1年的平均成功率如下：三个危险因素中没有一个，73.3%；一个危险因素，54.2%至63.6%(III-IV级触发为54.2%，BMI≥25kg/m2为63.6％，<6个月无症状期为63.6％）；两个危险因素，30％至75％（III-IV级和BMI≥25kg/m2的组合为30％，II-IV级和<6个月期间为45.5％，和75％，其中<6个月期和BMI≥25kg/m2）；以及所有三个危险因素，11.8%。
结论：对于喜欢非手术治疗的患者，应考虑反复注射皮质类固醇激素治疗，尤其是那些没有预测失败因素的人。
方法：预后II.
