Jessica Schmerler, Anthony K Chiu, Uzoma Ahiarakwe, R Timothy Kreulen, Uma Srikumaran, Matthew J Best
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引用次数: 0
Abstract
Background: Despite an established increased fracture risk in eating disorder patients, no studies, to our knowledge, have investigated the association between eating disorders and upper extremity soft tissue injury or surgery incidence. Given the association of eating disorders with nutritional deficiency and musculoskeletal sequelae, we hypothesized that patients with eating disorders would have an increased risk of soft tissue injury and surgery. The aim of this study was to elucidate this link and investigate if these incidences are increased in patients with eating disorders.
Methods: Cohorts of patients with anorexia ner-vosa or bulimia nervosa, identified using International Classification of Diseases (ICD) -9 and -10 codes, were identified in a large national claims database over 2010-2021. Control groups without these respective diagnoses were constructed, matched by age, sex, Charlson Comorbidity Index, record date, and geographical region. Upper extremity soft tissue injuries were identified using ICD-9 and -10 codes and surgeries using Current Procedural Terminology codes. Differences in incidence were analyzed using chi-square tests.
Results: Patients with anorexia and bulimia were significantly more likely to sustain a shoulder sprain (RR=1.77; RR=2.01, respectively), rotator cuff tear (RR=1.39; RR=1.62), elbow sprain (RR=1.85; RR=1.95), hand/wrist sprain (RR=1.73; RR=16.0), hand/wrist ligament rupture (RR=3.33; RR=1.85), any upper extremity sprain (RR=1.72; RR=1.85), or any upper extremity tendon rupture (RR=1.41; RR=1.65). Patients with bulimia were also more likely to sustain any upper extremity ligament rupture (RR=2.88). Patients with anorexia and bulimia were significantly more likely to undergo SLAP repair (RR=2.37; RR=2.03, respectively), rotator cuff repair (RR=1.77; RR=2.10), biceps tenodesis (RR=2.73; RR=2.58), any shoulder surgery (RR=2.02; RR=2.25), hand tendon repair (RR=2.09; RR=2.12), any hand surgery (RR=2.14; RR=2.22), or any hand/wrist surgery (RR=1.87; RR=2.06).
Conclusion: Eating disorders are associated with an increased incidence of numerous upper extremity soft tissue injuries and orthopaedic surgeries. Further work should be undertaken to elucidate the drivers of this increased risk. Level of Evidence: III.
期刊介绍:
Any original article relevant to orthopaedic surgery, orthopaedic science or the teaching of either will be considered for publication in The Iowa Orthopaedic Journal. Articles will be enthusiastically received from alumni, visitors to the department, members of the Iowa Orthopaedic Society, residents, and friends of The University of Iowa Department of Orthopaedics and Rehabilitation. The journal is published every June.