Multi-site Pain Is Associated with Long-term Patient-Reported Outcomes in Older Adults with Persistent Back Pain
| Autor: | Sean D. Rundell, David R. Nerenz, Melissa A Krook, Patrick J. Heagerty, Srdjan S. Nedeljkovic, Judith A. Turner, Pradeep Suri, Kushang V. Patel, Richard A. Deyo, Andrew L. Avins, Jeffrey G. Jarvik, Zoya Bauer, Janna L. Friedly |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Pain Cohort Studies 03 medical and health sciences Disability Evaluation 0302 clinical medicine Quality of life Back pain medicine Humans 030212 general & internal medicine Longitudinal Studies Patient Reported Outcome Measures Pelvis Aged Pain Measurement Aged 80 and over Groin business.industry General Medicine Odds ratio Middle Aged Confidence interval Anesthesiology and Pain Medicine medicine.anatomical_structure Treatment Outcome Physical therapy Quality of Life Accidental Falls Female Neurology (clinical) medicine.symptom Headaches business Low Back Pain 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Pain medicine (Malden, Mass.). 20(10) |
| ISSN: | 1526-4637 |
| Popis: | ObjectiveTo estimate the prevalence of co-occurring pain sites among older adults with persistent back pain and associations of multisite pain with longitudinal outcomes.DesignSecondary analysis of a cohort study.SettingThree integrated health systems in the United States.SubjectsEight hundred ninety-nine older adults with persistent back pain.MethodsParticipants reported pain in the following sites: stomach, arms/legs/joints, headaches, neck, pelvis/groin, and widespread pain. Over 18 months, we measured back-related disability (Roland Morris, scored 0–24), pain intensity (11-point numerical rating scale), health-related quality of life (EuroQol-5D [EQ-5D], utility from 0–1), and falls in the past three weeks. We used mixed-effects models to test the association of number and type of pain sites with each outcome.ResultsNearly all (N = 839, 93%) respondents reported at least one additional pain site. There were 216 (24%) with one additional site and 623 (69%) with multiple additional sites. The most prevalent comorbid pain site was the arms/legs/joints (N = 801, 89.1%). Adjusted mixed-effects models showed that for every additional pain site, RMDQ worsened by 0.65 points (95% confidence interval [CI] = 0.43 to 0.86), back pain intensity increased by 0.14 points (95% CI = 0.07 to 0.22), EQ-5D worsened by 0.012 points (95% CI = –0.018 to –0.006), and the odds of falling increased by 27% (odds ratio = 1.27, 95% CI = 1.12 to 1.43). Some specific pain sites (extremity pain, widespread pain, and pelvis/groin pain) were associated with greater long-term disability.ConclusionsMultisite pain is common among older adults with persistent back pain. Number of pain sites was associated with all outcomes; individual pain sites were less consistently associated with outcomes. |
| Databáze: | OpenAIRE |
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