Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury.
Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury.
复制标题
DOI：
10.2147/jpr.s38878
复制
发表时间：
2013
影响因子：
2.7
通讯作者：
Katz J
中科院分区：
文献类型：
--
作者：
Rosenbloom BN;Khan S;McCartney C;Katz J
持续性疼痛和心理困扰是常见的创伤性肌肉骨骼损伤（TMsI）。患有TMSI的人通常很年轻，不能很快恢复，并给社会带来巨大的经济负担。本系统综述的目的是确定（1）TMsI后持续性疼痛的发生率，（2）疼痛的特征，以损伤的严重程度和类型为特征，（3）与TMsI后持续性疼痛相关的风险和保护因素。对电子数据库（MEDLINE®、PubMed®、Embase和PsycINFO®）进行系统检索，以获得测量TMsI相关疼痛发生率的前瞻性、干预性或非干预性研究。共检索到4388项研究。11项研究检查了持续性疼痛，并符合纳入标准。在6项研究中，使用疼痛强度或疼痛存在的有效测量方法评估疼痛。所有研究均报告了持续性疼痛，在受伤后84个月的不同时间点，研究中疼痛强度（即从轻度到非常严重）和每个时间点的疼痛发生率存在很大差异。在每项研究中，疼痛的发生率随时间推移而降低。两项研究发现，损伤严重程度与持续性疼痛之间存在显着关系。经常被引用的持续性疼痛的预测因素包括：焦虑和抑郁症状，患者认为损伤归因于外部来源（即，他们没有过错），对痛苦想法的认知回避，创伤前饮酒，教育状况较低，工伤，赔偿资格，初始评估时的疼痛和年龄较大。本综述中包含的11项研究的证据表明，持续性疼痛在创伤性损伤后84个月内普遍存在。需要进一步的研究来更好地评估持续性疼痛和其他长期创伤后结果。
Persistent pain and psychological distress are common after traumatic musculoskeletal injury (TMsI). Individuals sustaining a TMsI are often young, do not recover quickly, and place a large economic burden on society. The aim of this systematic review is to determine (1) the incidence of persistent pain following TMsI, (2) the characteristics of pain, characterized by injury severity and type, and (3) risk and protective factors associated with persistent pain following TMsI. A systematic search of electronic databases (MEDLINE®, PubMed®, Embase, and PsycINFO®) was conducted for prospective, interventional, or noninterventional studies measuring the incidence of pain associated with TMsI. The search revealed 4388 studies. Eleven studies examined persistent pain and met inclusion criteria. Pain was assessed using a validated measure of pain intensity or pain presence in six studies. Persistent pain was reported by all studies at variable time points up to 84 months postinjury, with wide variation among studies in pain intensity (ie, from mild to very severe) and pain incidence at each time point. The incidence of pain decreased over time within each study. Two studies found significant relationships between injury severity and persistent pain. Frequently cited predictive factors for persistent pain included: symptoms of anxiety and depression, patient perception that the injury was attributable to external sources (ie, they were not at fault), cognitive avoidance of distressing thoughts, alcohol consumption prior to trauma, lower educational status, being injured at work, eligibility for compensation, pain at initial assessment, and older age. The evidence from the eleven studies included in this review indicates that persistent pain is prevalent up to 84 months following traumatic injury. Further research is needed to better evaluate persistent pain and other long-term posttraumatic outcomes.