Predictors of onset and progression of knee pain in adults living in the community. A prospective study
Predictors of onset and progression of knee pain in adults living in the community. A prospective study
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DOI：
10.1093/rheumatology/kem374
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发表时间：
2008-03-01
期刊：
影响因子：
5.5
通讯作者：
Croft, P.
中科院分区：
文献类型：
--
作者：
Jinks, C.;Jordan, K. P.;Croft, P.
目标。在以人群为基础的年龄为50岁的人群中，研究膝关节疼痛发生和进展的决定因素。在英国北斯塔福德郡注册了三家全科诊所的2982人的前瞻性队列研究。通过基线和3年的问卷调查，评估了人口统计学、膝关节相关和一般健康因素与新发膝关节疼痛的发病以及从非严重膝关节疼痛到严重膝关节疼痛的进展之间的关系。有效率分别为77%（基线）和75%（随访）。与膝关节疼痛发作显著相关的基线因素是膝关节损伤[比值比（OR） 1.6, 95% CI 1.2, 2.2]，抑郁（OR 1.4, 95% CI 1.1, 1.8），广泛性疼痛（OR 1.5, 95% CI 1.1, 1.9与无疼痛相比）和年轻。严重膝关节疼痛的发生与肥胖（比值比为2.9,95% CI为1.7,5.1）和身体限制（比值比为2.5,95% CI为1.5,4.1）以及广泛的疼痛、年龄、女性和合并症密切相关。从非严重到严重膝关节疼痛进展的最强独立预测因子是慢性（OR 3.1, 95% CI 2.1, 4.6）、既往医疗保健（OR 2.2, 95% CI 1.5, 3.3）和肥胖（OR 2.1, 95% CI 1.2, 3.6）。除了关注肥胖，还有可能通过处理膝关节损伤和治疗抑郁症来预防膝关节疼痛。其他因素可能决定膝盖疼痛是否会进一步恶化。未来研究的一个领域是当前医疗保健在人群水平上阻止或逆转膝关节疼痛进展的有效性。
Objective. To investigate determinants of the onset and progression of knee pain in a population-based sample of people aged >= 50 yrs.Methods. Prospective cohort study of 2982 people registered with three general practices in North Staffordshire, UK. Using questionnaire surveys at baseline and 3 yrs, demographic, knee-related and general health factors were assessed for their relationship with onset of new knee pain, and progression from non-severe to severe knee pain.Results. Response rates were 77% (baseline) and 75% (follow-up). Baseline factors significantly associated with onset of knee pain were knee injury [odds ratio (OR) 1.6, 95% CI 1.2, 2.2], depression (OR 1.4, 95% CI 1.1, 1.8), widespread pain (OR 1.5, 95% CI 1.1, 1.9 compared with no pain) and younger age. Onset of severe knee pain was associated most strongly with obesity (OR 2.9, 95% CI 1.7, 5.1) and physical limitations (OR 2.5, 95% CI 1.5, 4.1), and with widespread pain, older age, female gender and comorbidity. The strongest independent predictors of progression from non-severe to severe knee pain were chronicity (OR 3.1, 95% CI 2.1, 4.6), previous use of health care (OR 2.2, 95% CI 1.5, 3.3) and obesity (OR 2.1, 95% CI 1.2, 3.6).Conclusion. In addition to a focus on obesity, there is potential for primary prevention of knee pain by tackling knee injuries and treating depression. Other factors are likely to determine whether the knee pain then progresses. An area for future research is the ineffectiveness of current health care in halting or reversing progression of knee pain at a population level.