Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population
Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population
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DOI：
10.1186/1471-2474-7-66
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发表时间：
2006-08-14
影响因子：
2.3
通讯作者：
Thelin, Anders G.
中科院分区：
文献类型：
--
作者：
Holmberg, Sara A. C.;Thelin, Anders G.
背景：颈部和腰痛是常见的肌肉骨骼疾病，在西方人群中产生巨大的社会成本。在这项研究中，我们评估了颈部和腰痛的长期健康结果的严重程度，同时考虑了可能的混杂因素。方法：1989 年建立了一个由 2,351 名瑞典男性农民和农村非农民（40-60 岁）组成的队列。在 1990-91 年进行的第一次调查中，有 1,782 名男性参与。 2002-03 年进行了一项为期 12 年的跟踪调查，两次都有 1,405 名男性参与。排除 1990-91 年报告特定背部诊断的 58 名个人后，研究队列涵盖了 1,347 名男性。 2002-03 年，通过结构化访谈对初级保健咨询、住院、病假和残疾养老金等健康结果进行了评估（调查 2）。在调查 1 中评估了症状和潜在的混杂因素，但抑郁和焦虑的评级除外，在调查 2 中进行了评估。使用多元逻辑回归生成优势比 (OR)，置信区间 (95% CI) 为 95%，以调整报告的症状与潜在混杂因素（年龄、农业、工作量、教育、工作需求和控制、体重指数、吸烟、吸鼻烟、饮酒、精神症状和后续期间的特定背部诊断）的健康结果之间的关联。结果：在调查 1 中报告当前颈部和/或腰背疼痛的 836 名男性中，21% 的人至少接受过一次颈部或腰部问题的初级保健咨询，7% 的人在 12 年的随访期间请病假，4% 的人因这种情况领取残疾养老金。考虑潜在的混杂因素后，调查 1 中当前的颈部和/或腰痛预测初级保健咨询（OR = 4.10，95% CI 2.24-7.49）和病假（OR = 3.22，95% CI 1.13-9.22）。较低的教育程度和更多的精神症状与病假独立相关。较低的教育程度和鼻烟使用独立预测了残疾养老金。结论：在 12 年的随访期间，很少有颈部或腰痛患者因颈部或腰背问题而请病假或获得残疾养老金。基线症状独立预测健康结果。教育水平和抑郁/焦虑症状是重要的调节因素。
Background: Neck and low back pain are common musculoskeletal complaints generating large societal costs in Western populations. In this study we evaluate the magnitude of long-term health outcomes for neck and low back pain, taking possible confounders into account.Method: A cohort of 2,351 Swedish male farmers and rural non-farmers (40-60 years old) was established in 1989. In the first survey, conducted in 1990-91, 1,782 men participated. A 12-year follow-up survey was made in 2002-03 and 1,405 men participated at both times. After exclusion of 58 individuals reporting a specific back diagnosis in 1990-91, the study cohort encompassed 1,347 men. The health outcomes primary care consultation, hospital admission, sick leave and disability pension were assessed in structured interviews in 2002-03 (survey 2). Symptoms and potential confounders were assessed at survey 1, with the exception of rating of depression and anxiety, which was assessed at survey 2. Multiple logistic regression generating odds ratios (OR) with 95% confidence intervals (95% CI) was performed to adjust the associations between reported symptoms and health outcomes for potential confounders (age, farming, workload, education, demand and control at work, body mass index, smoking, snuff use, alcohol consumption, psychiatric symptoms and specific back diagnoses during follow up).Results: Of the 836 men reporting current neck and/or low back pain at survey 1, 21% had had at least one primary care consultation for neck or low back problems, 7% had been on sick leave and 4% had disability pension owing to the condition during the 12 year follow up. Current neck and/or low back pain at survey 1 predicted primary care consultations (OR = 4.10, 95% CI 2.24-7.49) and sick leave (OR = 3.22, 95% CI 1.13-9.22) after potential confounders were considered. Lower education and more psychiatric symptoms were independently related to sick leave. Lower education and snuff use independently predicted disability pension.Conclusion: Few individuals with neck or low back pain were on sick leave or were granted a disability pension owing to neck or low back problems during 12 years of follow up. Symptoms at baseline independently predicted health outcomes. Educational level and symptoms of depression/anxiety were important modifiers.