The importance of symptom duration in determining prognosis
The importance of symptom duration in determining prognosis
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DOI：
10.1016/j.pain.2005.12.012
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发表时间：
2006-03-01
期刊：
影响因子：
7.4
通讯作者：
Croft, PR
中科院分区：
文献类型：
--
作者：
Dunn, KM;Croft, PR
症状持续时间是疼痛的临床和流行病学研究的组成部分。它被广泛用于样本选择，并在临床实践中经常进行评估。然而，很少有具体的调查持续时间和结果之间的联系。这项工作的目的是检查发作持续时间与症状和临床过程中的初级保健咨询与腰痛（LBP）的关联。在一个队列的全科实践LBP咨询，619例患者返回两个或两个以上的问卷调查，在12个月的时间。基线咨询时LBP发作持续时间定义为自最后一个无痛月以来的时间。研究了持续时间与疼痛、残疾和基线心理状态的关系。生存分析用于评估发作持续时间与残疾改善30%所需时间之间的相关性。在基线时，增加发作持续时间与更严重的疼痛，残疾和心理状态相关（p < 0.001），但疼痛超过或少于3个月的人之间没有差异。基线时持续时间为3年或更长的人比持续时间较短的人需要更长的时间才能改善（调整后的风险比1.57，95%置信区间1.27-1.95）。总之，腰痛发作持续时间的记忆与疼痛、残疾和心理状态相关，是改善时间的独立预测因子。回忆起超过或少于3年持续时间的人之间存在重要差异。这些关联的机制知之甚少，但这项研究表明，持续时间本身是研究的一个重要焦点。(c)2005年国际疼痛研究协会。Elsevier B. V.出版，保留所有权利。
Symptom duration is integral to clinical and epidemiological research on pain. It is widely used for sample selection and commonly assessed in clinical practice. However, there has been little specific investigation of the link between duration and outcome. This work aimed to examine the association of episode duration with symptoms and clinical course in primary care consulters with low back pain (LBP). In a cohort of general practice LBP consulters, 619 patients returned two or more questionnaires during a 12-month period. LBP episode duration at baseline consultation was defined by time since their last pain-free month. Associations of duration with pain, disability and psychological status at baseline were examined. Survival analysis was used to assess the association between episode duration and time taken for disability to improve by 30%. At baseline, increasing episode duration was associated with worse pain, disability and psychological status (p < 0.001), but there were no differences between people with more or less than 3 months of pain. People with 3 years' or more duration at baseline took significantly longer to improve than those with shorter duration (adjusted hazard ratio 1.57, 95% confidence interval 1.27-1.95). In conclusion, memory of LBP episode duration is associated with pain, disability and psychological status, and is an independent predictor of time to improvement. There are important differences between people who recall more or less than 3 years' duration. Mechanisms for these associations are poorly understood, but this research suggests that duration itself is an important focus for research. (c) 2005 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.