目的:探讨老年肩周炎患者的危险因素。
方法:对我院2020年1月至2020年12月收治的262例肩周炎患者进行回顾性分析。根据患者的年龄,将年龄小于60岁的患者分为中年组(101例),将60至75岁的患者分为老年组(91例),≥75岁的患者分为老年组(70例)。比较3组的一般人口统计学资料和临床资料。采用视觉模拟评分法(VAS)评价疼痛程度。最后,因变量设定为肩周炎患者的发病年龄是否提前。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。
结果:一般人口统计学数据没有显着差异,固定位置,高血压病史,吸烟史,饮酒史,三组冈上肌萎缩和体育锻炼(均P>0.05)。疾病的进程,糖尿病,手术治疗,疼痛程度,操作时间,胆囊炎,冠心病,老年组术后3个月疼痛程度和颈椎病均高于中年组和老年组,差异均有统计学意义(均P<0.05)。肩周炎的病程,老年组的疼痛程度和术后3个月的疼痛程度均高于中年组,差异均有统计学意义(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%CI1.881~4.587,P<0.001)。手术治疗(OR=3.076,95%CI1.365-6.765,P=0.006),VAS评分(OR=2.267,95%CI1.117-3.887,P=0.013),手术时间(OR=1.537,95%CI1.305-2.579,P<0.001),胆囊炎(OR=2.143,95%CI1.019-4.876,P=0.023),冠心病(OR=3.128,95%CI1.428-7.019,P=0.005),术后3个月VAS(OR=1.537,95%CI0.786~2.635,P=0.002)。颈椎病(OR=1.162,95%CI1.029~1.321,P=0.012)。多因素logistic回归分析显示,高龄患者发病的危险因素为脂肪浸润(OR=4.021,95%CI2.981~9.682,P<0.001)。手术治疗(OR=4.109,95%CI1.419-7.832,P=0.008),VAS评分(OR=3.081,95%CI1.042~7.931,P=0.046)和手术时间(OR=1.537,95%CI1.305~2.579,P<0.001)。
结论:高龄冻结肩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,我们应该参考上述指标,以帮助患者进行早期医疗干预并防止其发作。
OBJECTIVE: To explore the risk factors of elderly patients with frozen shoulder.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.