125.
Suspected impingement syndrome – predictors of early closure of
treatment. A prospective study within the framework of the
ShoulderInterventionProject
Linda Christie Andrea, Poul Frost, Torben Bæk Hansen, Søren Rasmussen
Deutch, Susanne Wulff Svendsen
Danish Ramazzini Centre, Department of Occupational Medicine Herning
Regional Hospital; Danish Ramazzini Centre, Department of Occupational
Medicine, Aarhus University Hospital; Department of Orthopaedic Surgery,
Holstebro Regional Hospital; Department of Orthopaedic Surgery, Randers
Regional Hospital; Danish Ramazzini Centre, Department of Occupational
Medicine, Herning Regional Hospital
Background:
A large number of patients suspected of impingement
syndrome, are referred to an orthopaedic department for evaluation
Purpose / Aim of Study:
We hypothesised, that predictors of early closure of
an episode of care (EOC) after first consultation are: Oxford Shoulder Score
(
OSS), the diagnosis made by the orthopaedic surgeon, younger age, female
sex, co morbidity, self-reported depression, language difficulties,
unemployment, and ongoing (workers’) insurance claim
Materials and Methods:
We included all patients aged 18-63, suspected of
impingement syndrome based on referral letter, who provided questionnaire
information and were seen at one of six orthopaedic departments in Central
Denmark Region during 14 months. The departments registered diagnosis,
language difficulties, co morbidity, and closure of the EOC. Remaining risk
factors and Oxford Shoulder Score (OSS) were obtained from the
questionnaire. Logistic regression was used for analysis
Findings / Results:
1750
persons were included, 66.2% completed the
questionnaire. 30% (14- 38%) of the EOC were closed after first consultation.
Patients with ‘good’ shoulder function (OSS>32) without impingement
syndrome diagnosed had OR 3,7 (95% CI 2.2-6.2) for early closure of the
EOC - compared to patients who had both impingement syndrome and ‘poor'
shoulder function (OSS
≤
32).
The percentages with early closure of EOC were
43%
and 18%, respectively. None of the other risk factors considered were
significant predictors
Conclusions:
30%
of patients, referred with suspected impingement
syndrome, had their EOC closed after the first consultation. The probability of
early closure depended on diagnosis and shoulder status. All other tested
predictors showed no evidence. The perspective of general practitioners
determining OSS before referring patients for orthopaedic evaluation, could be
considered in the future
