Toward characterization and definition of fibromyalgia severity.
Toward characterization and definition of fibromyalgia severity.
复制标题
DOI：
10.1186/1471-2474-11-66
复制
发表时间：
2010-04-08
影响因子：
2.3
通讯作者：
Zlateva G
中科院分区：
文献类型：
--
作者：
Silverman S;Sadosky A;Evans C;Yeh Y;Alvir JM;Zlateva G
由于纤维肌痛与多个症状领域相关，因此没有标准标准来定义或评估纤维肌痛（FM）的严重程度。本研究的目的是评估患者自我报告的FM严重程度是否与疼痛和睡眠干扰的严重程度以及核心合并症的存在相关。我们招募了年龄≥ 18岁、经临床医生确认诊断为FM ≥ 3个月且当前疼痛评分在0-10数字评分量表（NRS）上>2的个体。患者通过邮件完成了一份问卷，其中他们自我评估了FM的严重程度（非常轻度、轻度、中度和重度），他们当前的疼痛严重程度和睡眠干扰程度（NRS;轻度，0-3;中度，4-6，重度，7-10），并提供了关于存在核心合并症的信息（是/否）（抑郁症，焦虑症，睡眠问题，背痛，颈部疼痛的症状）和FM的药物使用。对FM的核心症状进行分层，以协助患者表征。方差分析（ANOVA）用于探索自我报告的FM严重程度与连续变量（疼痛严重程度和睡眠干扰）之间的关系，Mantel-Haenszel卡方分析用于评估FM严重程度的患者报告药物使用和FM核心症状的比例趋势。为了补充患者报告的FM严重程度并了解医生的观点，在28名医生专家（流变学、神经学、麻醉学/疼痛管理、家庭实践、内科和精神病学）中进行了一项调查，以确定他们在临床实践中评价FM严重程度时的评估内容。FM患者人群（N = 129）主要为女性（89.1%），平均年龄为49.4 ± 11.0岁，81.4%报告的病程≥ 2年。86.0%的患者自我报告的FM严重程度为中度/重度;平均当前疼痛评分为6.40 ± 2.19（中度），平均睡眠干扰评分为7.28 ± 2.23（重度）。FM严重程度越高，当前疼痛和睡眠干扰水平越高（p < 0.0001），报告使用FM药物的患者比例（p = 0.0001），以及核心合并症的存在（p < 0.05）。在评价FM严重程度时，疼痛、功能障碍和疲劳严重程度被最高比例的医生列为前三位标准。自我报告的FM严重程度越高，患者的疼痛和睡眠干扰越大，核心合并症的频率也越高。需要进一步调查以了解FM严重性。
There are no standard criteria for defining or assessing severity of fibromyalgia (FM) as a condition as fibromyalgia is associated with multiple symptom domains. The objective of this study was to evaluate whether patient self-reported severity of FM is associated with severity of pain and sleep interference and the presence of core co-morbidities. We recruited individuals ≥ 18 years of age with a clinician-confirmed diagnosis of FM ≥ 3 months and a current pain rating >2 on a 0-10 numeric rating scale (NRS). Patients completed a questionnaire by mail in which they self-rated their FM severity (very mild, mild, moderate, and severe), their current pain severity and extent of sleep interference (NRS; mild, 0-3; moderate, 4-6, severe, 7-10), and provided information (yes/no) on the presence of core comorbidities (symptoms of depression, anxiety, sleep problems, back pain, neck pain) and medication use for FM. The core symptoms of FM were stratified to assist with patient characterization. Analysis of variance (ANOVA) was used to explore the relationship between self-reported FM severity and continuous variables (pain severity and sleep interference), and Mantel-Haenszel chi-square analysis was used to evaluate the trend in the proportions of patients reporting use of medications and core symptoms of FM by severity of FM. To complement patient-reported FM severity and to understand physicians' perspectives, a survey was performed among 28 physician specialists (rheumatology, neurology, anesthesiology/pain management, family practice, internal medicine, and psychiatry) to determine what they assessed when evaluating FM severity in clinical practice. The population (N = 129) of FM patients was predominantly female (89.1%), with a mean age of 49.4 ± 11.0 years, and 81.4% reported duration ≥ 2 years. Self-reported FM severity was moderate/severe in 86.0% of patients; mean current pain score was 6.40 ± 2.19 (moderate), and mean sleep interference score was 7.28 ± 2.23 (severe). Greater FM severity was significantly associated with higher levels of current pain and sleep interference (p < 0.0001), the proportion of patients reporting FM medication use (p = 0.0001), and the presence of core comorbidities (p < 0.05). Pain, functional disability, and fatigue severity were ranked as the top three criteria by the highest proportion of physicians when evaluating FM severity. With higher self-reported FM severity, patients have greater pain and sleep interference as well as increased frequency of core comorbidities. Further investigation into understanding FM severity is warranted.
登录
查看更多内容
影响因子：
--
作者：
Lawrence, Reva C.;Felson, David T.;Wolfe, Frederick
通讯作者：
Wolfe, Frederick
DOI：
10.1097/jom.0b013e31815cff4b
发表时间：
2008-01-01
影响因子：
3.2
作者：
White, Leigh Ann;Birnbaum, Howard G.;Robinson, Rebecca L.
通讯作者：
Robinson, Rebecca L.
影响因子：
5.5
作者：
Strand, V;Cohen, S;Scott, DL
通讯作者：
Scott, DL
影响因子：
--
作者：
Unden, Anna-Lena;Elofsson, Stig
通讯作者：
Elofsson, Stig
影响因子：
4
作者：
McVeigh, J. G.;Finch, M. B.;Baxter, G. D.
通讯作者：
Baxter, G. D.