Analysis of the Epidemiological and Surgical Predictors of Frozen shoulder Observed in a 5-year Pilot at Zhejiang Provincial Hospital of Chinese Medicine

Abstract

Abstract Background Frozen shoulder constitutes a disease category associated with significant clinical morbidity and complications. However, the precise risk factors contributing to its development remaining unidentified. In this study, a clinical database was established through the collection of medical records from frozen shoulder patients who were hospitalized in the Department of Tuina at The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine) between 1 January 2017 and 30 December 2022. A randomized case-control design was employed to identify potential risk factors by analyzing the demographic characteristics of the patients. Additionally, logistic regression analysis was conducted to ascertain the prognostic risks associated with frozen shoulder, including factors such as age, gender, and surgical interventions. Methods A total of 176 patients with frozen shoulder with a median age of 55.94 years were enrolled in this study. Complicated diabetes (B, 2.517; OR, 12.396; 95% CI, 3.656-42. 028; P=.000), and cervical spondylosis (B, 1.495; OR, 4.459; 95% CI, 1.857-10.709; P=.001) were at higher risk in patients with bursitis compared to controls. In the intention to treat analysis (ITT) population, 125 persons choose surgical treatment and 51 choose conservative treatment, and long duration of illness (B, -0.716; OR, 0.489; 95% CI, 0.260-0.916; P=.026) and long hospital stay (B, 0.46; OR, 1.582; 95% CI, 1.008-2.482; P=.046), accompanied by cervical spondylosis (B, 1.149; OR, 3.155; 95% CI, 1. 335-7.453; P=.009) and hypertension (B, 1.279; OR, 3.593; 95% CI, 1.508-8.556; P=.004) patients were more likely to opt for surgery, and health insurance had little impact on whether patients operated or not (P>0.05). Results The study identified various risk factors for frozen shoulder, including obesity, thyroid nodules, diabetes, and cervical spondylosis. Additionally, patients with long-term disease, short hospital stays, and concomitant hypertension or cervical spondylosis demonstrated a higher likelihood of choosing surgical intervention.