Demographic and medical parameters in the development of complex regional pain syndrome type 1 (CRPS1): Prospective study on 596 patients with a fracture
Demographic and medical parameters in the development of complex regional pain syndrome type 1 (CRPS1): Prospective study on 596 patients with a fracture
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1型复杂性区域疼痛综合征（CRPS1）发病过程中的人口统计学和医学参数： 对 596 名骨折患者的前瞻性研究
DOI：
10.1016/j.pain.2012.01.026
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发表时间：
2012-06-01
期刊：
影响因子：
7.4
通讯作者：
Huygen, Frank J. P. M.
中科院分区：
文献类型：
--
作者：
Beerthuizen, Annemerle;Stronks, Dirk L.;Huygen, Frank J. P. M.
关于1型复杂局部疼痛综合征（CRPS1）的发生率以及导致CRPS1发病的人口统计学和医学风险因素的数据有限。本研究的目的是使用3套诊断标准调查骨折患者CRPS1的发生率，并评估人口统计学/医学因素与以Harden和Bruehl标准诊断的CRPS1的发展之间的关系。一项前瞻性多中心队列研究纳入了596例（18岁及以上）腕部、舟状骨、踝关节或跖骨V骨折的患者，患者来自荷兰3家医院的急诊室。在596名参与者中，42名（7.0%）根据Harden and Bruehl标准诊断为CRPS1, 289名（48.5%）根据国际疼痛研究协会标准诊断为CRPS1, 127名（21.3%）根据Veldman标准诊断为CRPS1。对医学和人口统计学差异的分析显示，CRPS1后来发展的患者更常发生关节内骨折、骨折脱位、类风湿关节炎或肌肉骨骼合并症。踝关节骨折、脱位和关节内骨折是预测CRPS1发生的重要因素。没有CRPS1患者在12个月（T3）时症状消失。在基线时，有CRPS1的患者比没有CRPS1的患者有更多的疼痛(P
Limited data are available on the incidence of complex regional pain syndrome type 1 (CRPS1) and on demographic and medical risk factors for the development of CRPS1. The objective of this study was to investigate the incidence of CRPS1 in patients with a fracture using 3 sets of diagnostic criteria and to evaluate the association between demographic/medical factors and the development of CRPS1 diagnosed with the Harden and Bruehl criteria. A prospective multicenter cohort study of 596 patients (ages 18 years and older) with a single fracture of the wrist, scaphoid, ankle, or metatarsal V, recruited patients from the emergency rooms of 3 Dutch hospitals. Of the 596 participants, 42 (7.0%) were diagnosed with CRPS1 according to the Harden and Bruehl criteria, 289 (48.5%) according to the International Association for the Study of Pain criteria, and 127 (21.3%) according to the criteria of Veldman. An analysis of the medical and demographic differences revealed that patients in whom CRPS1 later developed more often had intra-articular fractures, fracture dislocations, rheumatoid arthritis, or musculoskeletal comorbidities. An ankle fracture, dislocation, and an intra-articular fracture contributed significantly to the prediction of the development of CRPS1. No CRPS1 patients were symptom free at 12 months (T3). At baseline, patients with CRPS1 had significantly more pain than patients without CRPS1 (P