Risk Factors for Surgery Due to Rotator Cuff Disease in a Population-Based Cohort

Details

• Personal Author:
  Colditz GA ; Dale, Ann M. ; Evanoff BA ; Jain NB ; Keener JD ; Saccone NL ; Wright RW ; Yanik EL
• Description:
  Aims: Few risk factors for rotator cuff disease (RCD) and corresponding treatment have been firmly established. The aim of this study was to evaluate the relationship between numerous risk factors and the incidence of surgery for RCD in a large cohort. Methods: A population-based cohort of people aged between 40 and 69 years in the UK (the UK Biobank) was studied. People who underwent surgery for RCD were identified through a link with NHS inpatient records covering a mean of eight years after enrolment. Multivariate Cox proportional hazards regression was used to calculate hazard ratios (HRs) as estimates of associations with surgery for RCD accounting for confounders. The risk factors which were considered included age, sex, race, education, Townsend deprivation index, body mass index (BMI), occupational demands, and exposure to smoking. Results: Of the 421,894 people who were included, 47% were male. The mean age at the time of enrolment was 56 years (40 to 69). A total of 2,156 people were identified who underwent surgery for RCD. Each decade increase in age was associated with a 55% increase in the incidence of RCD surgery (95% confidence interval (CI) 46% to 64%). Male sex, non-white race, lower deprivation score, and higher BMI were significantly associated with a higher risk of surgery for RCD (all p < 0.050). Greater occupational physical demands were significantly associated with higher rates of RCD surgery (HR = 2.1, 1.8, and 1.4 for 'always', 'usually', and 'sometimes' doing heavy manual labour vs 'never', all p < 0.001). Former smokers had significantly higher rates of RCD surgery than those who had never smoked (HR 1.23 (95% CI 1.12 to 1.35), p < 0.001), while current smokers had similar rates to those who had never smoked (HR 0.94 (95% CI 0.80 to 1.11)). Among those who had never smoked, the risk of surgery was higher among those with more than one household member who smoked (HR 1.78 (95% CI 1.08 to 2.92)). The risk of RCD surgery was not significantly related to other measurements of secondhand smoking. Conclusion: Many factors were independently associated with surgery for RCD, including older age, male sex, higher BMI, lower deprivation score, and higher occupational physical demands. Several of the risk factors which were identified are modifiable, suggesting that the healthcare burden of RCD might be reduced through the pursuit of public health goals, such as reducing obesity and modifying occupational demands. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Epidemiology Musculoskeletal Diseases Musculoskeletal System Occupational Health Safety
• Keywords:
  BMI Body Mass Index Cohort Studies MSD Musculoskeletal Disorders Population Based Studies Surgery Upper Extremities
• ISSN:
  2049-4394
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Missouri ; OSHA Region 4 ; OSHA Region 7 ; Tennessee
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  352-359
• Volume:
  102
• Issue:
  3
• NIOSHTIC Number:
  nn:20068428
• Citation:
  Bone Joint J 2020 Mar; 102-B(3):352-359
• Contact Point Address:
  Elizabeth L. Yanik, Department of Orthopaedic Surgery, Washington University, School of Medicine, St. Louis, MO, United States
• Email:
  yanike@wustl.edu
• Federal Fiscal Year:
  2020
• Performing Organization:
  Washington University, St. Louis, Missouri
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  The Bone & Joint Journal
• End Date:
  20190831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:aa47c2f1383e7779058bff2500e46cfa2371d575fbad4cb41ac28bd40259c07412c0f541e78985b360cb1db6580ecdabced48ac8511f34410fb56de9a123cc6a
• Download URL:
  https://stacks.cdc.gov/view/cdc/230584/cdc_230584_DS1.pdf
• File Type:
  [PDF - 402.65 KB ]