Shoulder Symptom Trajectories Over Four Years: Data From a Longitudinal Study on Osteoarthritis

IF 3.7 2区医学 Q1 RHEUMATOLOGY

Arthritis Care & Research Pub Date : 2024-06-24 DOI:10.1002/acr.25383

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":null,"pages":null},"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.

Abstract Image

查看原文本刊更多论文

四年来的肩部症状轨迹：一项骨关节炎纵向研究的数据。

目的：有关肩部症状自然史的数据有限。我们旨在描述肩部症状的纵向模式，并确定发病率和持续性的风险因素：方法：我们使用骨关节炎倡议参与者的数据，对其进行了为期 4 年的年度随访，并使用描述性分析描述了肩部症状（是/否、侧面）的发生率和流行率。回归分析研究了三种肩部症状结果（持续性、偶发性和间歇性）与临床因素之间的关联。潜类增长分析（LCGA）确定了在≥1个时间点报告疼痛的患者的轨迹：共纳入 4796 名参与者（58% 为女性，平均年龄 61.2 岁）。基线肩部症状发生率为 22%；其中 32% 报告了双侧症状。在报告右侧症状的人中，260/1886（14%）人有持续性症状。有持续症状者的基线和四年临床状况较差（功能、心理健康和生活质量较差）。在回归分析中，持续症状与以下因素相关：调整后 OR（95% CI）：睡眠障碍（1.97（1.49，2.62））、旷工（2.16（1.38，2.62））、下肢无力（1.76（1.37，2.27））、多部位关节症状（≥3 个关节，不包括肩部）4.90（2.79，8.58）和白人（1.39（1.04，1.88）。下肢无力也与偶发症状有关；没有变量与间歇性症状有关。LCGA确定了两种轨迹：症状发生概率高的轨迹（占LCGA分析队列的9%）显示出与持续症状组临床变量相似的关系：在这项为期4年的大型研究中，持续性肩部症状很常见，并且与较差的临床结果相关。至少有一个风险因素是可以改变的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Arthritis Care & Research RHEUMATOLOGY-

CiteScore

9.40

自引率

6.40%

发文量

368

审稿时长

3-6 weeks

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.