Gui Tran, Bright Dube, Sarah R. Kingsbury, Philip G. Conaghan
{"title":"Shoulder Symptom Trajectories Over Four Years: Data From a Longitudinal Study on Osteoarthritis","authors":"Gui Tran, Bright Dube, Sarah R. Kingsbury, Philip G. Conaghan","doi":"10.1002/acr.25383","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>Limited data exist on the natural history of shoulder symptoms. We aimed to describe longitudinal patterns of shoulder symptoms and determine risk factors for incidence and persistence.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Data from Osteoarthritis Initiative participants observed annually for four years were used to describe shoulder symptom (yes/no, side) incidence and prevalence using descriptive analyses. Regression analyses investigated the association among three shoulder symptoms outcomes (persistent, incident, and intermittent) and clinical factors. Latent class growth analysis (LCGA) identified trajectories in those reporting pain at one or more time point.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In total, 4,796 participants (58% women, mean age 61.2 years) were included. Baseline shoulder symptom prevalence was 22%; 32% of these reported bilateral symptoms. In those reporting right symptoms, 260 of 1,886 (14%) had persistent symptoms. Those with persistent symptoms had worse baseline and four-year clinical status (poorer function, mental health, and quality of life). In regression analysis, persistent symptoms were associated with sleep disturbance (adjusted odds ratio [aOR] 1.97, 95% confidence interval [95% CI] 1.49–2.62), work absenteeism (aOR 2.16, 95% CI 1.38–2.62), lower limb weakness (aOR 1.76, 95% CI 1.37–2.27), multiple-site joint symptoms (≥3 joints excluding shoulders) (aOR 4.90, 95% CI 2.79–8.58) and White race (aOR 1.39, 95% CI 1.04–1.88). Lower limb weakness was also associated with incident symptoms; no variables were associated with intermittent symptoms. LCGA identified two trajectories: the trajectory with high probability for symptoms (9% of LCGA analysis cohort) showed similar relationships to clinical variables as in the persistent symptoms group.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In this large, four-year study, persistent shoulder symptoms were common and associated with worse clinical outcomes. At least one risk factor for incident symptoms is modifiable.</p>\n </section>\n </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"76 10","pages":"1436-1443"},"PeriodicalIF":3.7000,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25383","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthritis Care & Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/acr.25383","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Limited data exist on the natural history of shoulder symptoms. We aimed to describe longitudinal patterns of shoulder symptoms and determine risk factors for incidence and persistence.
Methods
Data from Osteoarthritis Initiative participants observed annually for four years were used to describe shoulder symptom (yes/no, side) incidence and prevalence using descriptive analyses. Regression analyses investigated the association among three shoulder symptoms outcomes (persistent, incident, and intermittent) and clinical factors. Latent class growth analysis (LCGA) identified trajectories in those reporting pain at one or more time point.
Results
In total, 4,796 participants (58% women, mean age 61.2 years) were included. Baseline shoulder symptom prevalence was 22%; 32% of these reported bilateral symptoms. In those reporting right symptoms, 260 of 1,886 (14%) had persistent symptoms. Those with persistent symptoms had worse baseline and four-year clinical status (poorer function, mental health, and quality of life). In regression analysis, persistent symptoms were associated with sleep disturbance (adjusted odds ratio [aOR] 1.97, 95% confidence interval [95% CI] 1.49–2.62), work absenteeism (aOR 2.16, 95% CI 1.38–2.62), lower limb weakness (aOR 1.76, 95% CI 1.37–2.27), multiple-site joint symptoms (≥3 joints excluding shoulders) (aOR 4.90, 95% CI 2.79–8.58) and White race (aOR 1.39, 95% CI 1.04–1.88). Lower limb weakness was also associated with incident symptoms; no variables were associated with intermittent symptoms. LCGA identified two trajectories: the trajectory with high probability for symptoms (9% of LCGA analysis cohort) showed similar relationships to clinical variables as in the persistent symptoms group.
Conclusion
In this large, four-year study, persistent shoulder symptoms were common and associated with worse clinical outcomes. At least one risk factor for incident symptoms is modifiable.
期刊介绍:
Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.