title: Arthroscopic subacromial decompression and predictors of long-term sick leave benefit and permanent benefits.
abstract: BACKGROUND
  Shoulder impingement syndrome is a common musculoskeletal complaint leading to reduced work ability. The aim of the present study was to identify predictors of long-term sick leave benefit and permanent benefits/permanently reduced work ability after arthroscopic subacromial decompression (ASD).
  
  
  METHODS
  The study included 615 individuals undergoing ASD (2003 to 2009). Data were linked to the 3 state registries concerning employment/benefits, medication, and industrial injuries. All individuals were monitored for 1 year, and 155 obtained complete 5-year follow-up. Risks were estimated in multivariate logistic regression models.
  
  
  RESULTS
  At 1 year after ASD, 16.6% were receiving sick leave benefit. The reduced multiple logistic regression model (odds ratio [95% confidence interval]) included painkillers (2.18 [1.37-3.46]), strong painkillers/opioids (3.78 [2.32-6.16]), and age (0.97 [0.94-0.995]). At 5 years after ASD, 35 (22.6%) were receiving permanent benefit. Predictors (odds ratio [95% confidence interval] were transfer income 2 years before ASD (3.44 [1.20-9.86]), use of opioids at any time during a 1-year period after ASD (24.80 [7.05-87.18]), or other work claims not due to shoulder disease (5.99 [1.34-26.72]).
  
  
  CONCLUSIONS
  A high percentage were receiving sick leave benefit 1 year after ASD, and nearly a quarter were receiving a permanent benefit 5 years after ASD. Medication before ASD was not a predictor of outcome. The strongest predictor of long-term sick leave benefit and permanent benefit was opioid use during the first year after ASD. This may indicate that pain after surgery may be an issue that needs further attention.
authors: Department of Social Medicine, Aalborg Hospital, Aarhus University Hospital, Havrevangen 1, Aalborg, Denmark. magrr@rn.dk
authors: Marianne
authors: M
authors: Rudbeck
authors: Steen Lund
authors: SL
authors: Jensen
authors: Kirsten
authors: K
authors: Fonager
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D001182:Arthroscopy; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D020127:Recovery of Function; D012189:Retrospective Studies; D019534:Shoulder Impingement Syndrome / Q000209:etiology / Q000601:surgery*; D018582:Sick Leave; D013997:Time Factors; D016896:Treatment Outcome; D014942:Workers' Compensation
chemical_list: D000701:Analgesics, Opioid
keywords: Level II; Prognosis Study; Retrospective Study; Shoulder; arthroscopic subacromial decompression; permanent benefit; sick leave; work ability