Cargando…
Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study
OBJECTIVES: Autoimmune connective tissue diseases (ACTDs) commonly involve the shoulder joint; however, clinical epidemiological studies investigating their association with tendons are scant. Rotator cuff (RC) tears can cause shoulder disability, and surgical intervention is usually required. The s...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398915/ https://www.ncbi.nlm.nih.gov/pubmed/30808669 http://dx.doi.org/10.1136/bmjopen-2018-023848 |
_version_ | 1783399666066391040 |
---|---|
author | Huang, Shih-Wei Lin, Che-Li Lin, Li-Fong Huang, Chi-Chang Liou, Tsan-Hon Lin, Hui-Wen |
author_facet | Huang, Shih-Wei Lin, Che-Li Lin, Li-Fong Huang, Chi-Chang Liou, Tsan-Hon Lin, Hui-Wen |
author_sort | Huang, Shih-Wei |
collection | PubMed |
description | OBJECTIVES: Autoimmune connective tissue diseases (ACTDs) commonly involve the shoulder joint; however, clinical epidemiological studies investigating their association with tendons are scant. Rotator cuff (RC) tears can cause shoulder disability, and surgical intervention is usually required. The study investigated RC repair surgery risk in ACTD patients. The effect of anti-inflammatory medication on RC repair surgery risk was also investigated. METHODS: We conducted a retrospective cohort study with a 7-year longitudinal follow-up period. Patients with systemic lupus erythematosus, systemic sclerosis, sicca syndrome, dermatomyositis and polymyositis diagnoses between 2004 and 2008 were enrolled. The control cohort comprised age- and sex-matched controls. The HR and adjusted HR (aHR) were estimated for the risk of RC surgery between ACTD and control cohorts after adjustment for confounders. Furthermore, the effects of steroid and non-steroidal anti-inflammatory drug (NSAID) use on the HR and aHR of RC surgery risk were analysed. RESULTS: We enrolled 5019 ACTD patients and 25 095 controls in the ACTD and control cohorts, respectively. RC surgery incidence was 49 and 24 per 100 000 person-years in the ACTD and control cohorts, respectively. In the ACTD cohort, the crude HR for RC surgery was 2.08 (95% CI, 1.08 to 4.02, p<0.05), and the aHR was 1.97 (95% CI, 1.01 to 3.82, p<0.05). The ACTD patients who used NSAIDs had an aHR of 3.13 (95% CI, 1.21 to 8.07, p<0.05) compared with the controls, but the ACTD patients who used steroids did not have a significantly higher aHR than the controls. CONCLUSIONS: ACTD patients had an increased risk of RC repair surgery. However, no difference was found in RC surgery risk when steroids were used compared with the control cohort. This could indicate that inflammation control may be a strategy for managing subsequent RC lesions. |
format | Online Article Text |
id | pubmed-6398915 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-63989152019-03-21 Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study Huang, Shih-Wei Lin, Che-Li Lin, Li-Fong Huang, Chi-Chang Liou, Tsan-Hon Lin, Hui-Wen BMJ Open Rheumatology OBJECTIVES: Autoimmune connective tissue diseases (ACTDs) commonly involve the shoulder joint; however, clinical epidemiological studies investigating their association with tendons are scant. Rotator cuff (RC) tears can cause shoulder disability, and surgical intervention is usually required. The study investigated RC repair surgery risk in ACTD patients. The effect of anti-inflammatory medication on RC repair surgery risk was also investigated. METHODS: We conducted a retrospective cohort study with a 7-year longitudinal follow-up period. Patients with systemic lupus erythematosus, systemic sclerosis, sicca syndrome, dermatomyositis and polymyositis diagnoses between 2004 and 2008 were enrolled. The control cohort comprised age- and sex-matched controls. The HR and adjusted HR (aHR) were estimated for the risk of RC surgery between ACTD and control cohorts after adjustment for confounders. Furthermore, the effects of steroid and non-steroidal anti-inflammatory drug (NSAID) use on the HR and aHR of RC surgery risk were analysed. RESULTS: We enrolled 5019 ACTD patients and 25 095 controls in the ACTD and control cohorts, respectively. RC surgery incidence was 49 and 24 per 100 000 person-years in the ACTD and control cohorts, respectively. In the ACTD cohort, the crude HR for RC surgery was 2.08 (95% CI, 1.08 to 4.02, p<0.05), and the aHR was 1.97 (95% CI, 1.01 to 3.82, p<0.05). The ACTD patients who used NSAIDs had an aHR of 3.13 (95% CI, 1.21 to 8.07, p<0.05) compared with the controls, but the ACTD patients who used steroids did not have a significantly higher aHR than the controls. CONCLUSIONS: ACTD patients had an increased risk of RC repair surgery. However, no difference was found in RC surgery risk when steroids were used compared with the control cohort. This could indicate that inflammation control may be a strategy for managing subsequent RC lesions. BMJ Publishing Group 2019-02-25 /pmc/articles/PMC6398915/ /pubmed/30808669 http://dx.doi.org/10.1136/bmjopen-2018-023848 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Rheumatology Huang, Shih-Wei Lin, Che-Li Lin, Li-Fong Huang, Chi-Chang Liou, Tsan-Hon Lin, Hui-Wen Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study |
title | Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study |
title_full | Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study |
title_fullStr | Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study |
title_full_unstemmed | Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study |
title_short | Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study |
title_sort | autoimmune connective tissue diseases and the risk of rotator cuff repair surgery: a population-based retrospective cohort study |
topic | Rheumatology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398915/ https://www.ncbi.nlm.nih.gov/pubmed/30808669 http://dx.doi.org/10.1136/bmjopen-2018-023848 |
work_keys_str_mv | AT huangshihwei autoimmuneconnectivetissuediseasesandtheriskofrotatorcuffrepairsurgeryapopulationbasedretrospectivecohortstudy AT lincheli autoimmuneconnectivetissuediseasesandtheriskofrotatorcuffrepairsurgeryapopulationbasedretrospectivecohortstudy AT linlifong autoimmuneconnectivetissuediseasesandtheriskofrotatorcuffrepairsurgeryapopulationbasedretrospectivecohortstudy AT huangchichang autoimmuneconnectivetissuediseasesandtheriskofrotatorcuffrepairsurgeryapopulationbasedretrospectivecohortstudy AT lioutsanhon autoimmuneconnectivetissuediseasesandtheriskofrotatorcuffrepairsurgeryapopulationbasedretrospectivecohortstudy AT linhuiwen autoimmuneconnectivetissuediseasesandtheriskofrotatorcuffrepairsurgeryapopulationbasedretrospectivecohortstudy |