Smoking Cessation Related to Improved Patient-Reported Pain Scores Following Spinal Care in Geriatric Patients
Smoking Cessation Related to Improved Patient-Reported Pain Scores Following Spinal Care in Geriatric Patients
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DOI：
10.1177/2151458514550479
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发表时间：
2014-12-01
影响因子：
1.6
通讯作者：
Rechtine, Glenn
中科院分区：
文献类型：
--
作者：
Behrend, Caleb;Schonbach, Etienne;Rechtine, Glenn
前言：我们在老年患者人群中研究了戒烟率和戒烟对疼痛和残疾评分的影响。方法：对6779例疼痛性脊柱疾病患者的前瞻性数据库记录进行检查。平均护理时间为8个月。以吸烟状况、继发获益状况、性别、治疗类型、抑郁症、年龄等自变量进行多因素统计分析。结果：在寻求治疗疼痛性脊柱疾病的患者中，55岁以上的吸烟者占8.9%，55岁以下的吸烟者占23.9%。55岁以上患者（25.1%）和年轻患者（26.1%）的戒烟率没有差异。在所有疼痛评分中，两个年龄组中当前吸烟者报告的疼痛都大于从未吸烟的人（P < 0.001）。在两个年龄组中，不吸烟者和当前吸烟者在治疗过程中报告的疼痛的平均改善有显著差异（P < 0.001）。那些在治疗过程中戒烟的人比那些继续吸烟的人在疼痛方面有更大的改善。在所有三组不吸烟的患者中，疼痛评分的平均改善具有临床意义，而那些继续吸烟的患者在报告的疼痛方面没有临床显着改善。结论：考虑到改善患者报告的疼痛与戒烟之间的强烈关联，研究结果支持戒烟计划的必要性。老年患者吸烟较少，但他们同样可能戒烟。
Introduction: We examined rates of smoking cessation and the effect of smoking cessation on pain and disability scores in a geriatric patient population. Methods: Prospectively maintained database records of 6779 patients treated for painful spinal disorders were examined. The mean duration of care was 8 months. Multivariate statistical analysis was performed with independent variables including smoking status, secondary gain status, gender, treatment type, depression, and age. Results: Of the patients seeking care for painful spinal disorders, 8.9% over the age of 55 smoked compared with 23.9% of those under 55 years of age. Rates of smoking cessation did not differ for those older than 55 years (25.1%) and younger patients (26.1%). Current smokers in both age-groups reported greater pain than those who had never smoked in all pain ratings (P < .001). Mean improvement in reported pain over the course of treatment was significantly different in nonsmokers and current smokers in both age-groups (P < .001). Those who quit smoking during the course of care reported greater improvement in pain than those who continued to smoke. The mean improvement in pain ratings was clinically significant in patients in all 3 groups of nonsmokers whereas those who continued to smoke had no clinically significant improvement in reported pain. Conclusion: The results support the need for smoking cessation programs, given a strong association between improved patient-reported pain and smoking cessation. Fewer older patients smoke but they are equally likely to quit.