Psychosocial predictors of persistent low back pain in patients presenting to the emergency department
Psychosocial predictors of persistent low back pain in patients presenting to the emergency department
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DOI：
10.1016/j.ajem.2021.10.018
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发表时间：
2021-10-22
影响因子：
3.6
通讯作者：
Majkowicz, Mikolaj
中科院分区：
文献类型：
--
作者：
Basinski, Krzysztof;Zdun-Ryzewska, Agata;Majkowicz, Mikolaj
目的：慢性腰痛是一个重要的公共卫生问题，产生很高的经济和社会成本。虽然大多数临床指南强调在初级保健中管理腰痛的重要性，但在实践中，不成比例的腰痛患者出现在急诊科。到急诊科就诊的患者可能形成一个特定的群体，具有导致慢性化的不同因素。这项前瞻性队列研究旨在确定持续性腰痛的社会人口统计学和心理预测因素，以及因疼痛而到急诊室就诊的急性症状患者的病假时间。方法：至少三个月内首次发作非特异性急性腰痛的患者有资格参加本研究。参与者填写了一系列问卷，包括疼痛、疼痛相关残疾、抑郁、焦虑和疼痛应对策略的测量。三个月后进行了结构化的电话采访有关疼痛和病假长度的问题。结果：110例患者参加了这项研究。97例患者完成随访，70.1%的患者在3个月后出现疼痛。较低的自评健康预测三个月后的疼痛。较长的病假长度预测较低的自测健康，分心的应对策略和减少行为activity.Conclusion：由于其简单性，自测健康的测量可包括在未来的临床实践中评估持续性疼痛的风险。(C)2021作者（S）爱思唯尔公司出版
Objectives: Chronic low back pain is an important public health problem, generating high financial and social costs. While most clinical guidelines stress the importance of managing low back pain in primary care, in practice a disproportionate amount of patients with low back pain present to emergency departments. Patients presenting to emergency departments may form a specific group with different factors leading to chronicity. This prospective cohort study aimed to determine the sociodemographic and psychological predictors of persistent low back pain and the length of sick leave due to pain in patients with acute symptoms visiting an emergency department.Methods: Patients with a first episode of non-specific acute low back pain in at least three months were qualified for this study. The participants filled a battery of questionnaires, including measures of pain, pain-related disability, depression, anxiety and pain coping strategies. A structured telephone interview was performed after three months with questions regarding pain and the length of sick leave.Results: 110 patients participated in the study. 97 patients completed the follow-up, with 70.1% suffering from pain after three months. Lower self-rated health predicted pain after three months. Longer length of sick leave was predicted by lower self-rated health, distraction as a coping strategy and decreased behavioral activity.Conclusion: Because of its simplicity, a measurement of self-rated health may be included in future clinical practice for assessing the risk of persistent pain. (C) 2021 The Author(s). Published by Elsevier Inc.