Kjellman G, Skargren E, Oberg B
Department of Neuroscience and Locomotion, Faculty of Health Sciences, Linköpings Universitet, Sweden.
Disabil Rehabil. 2002 May 10;24(7):364-70. doi: 10.1080/10.1080/09638280110101532.
To identify prognostic factors for perceived pain and function with focus at one-year follow-up in primary care patients treated for non-specific neck pain.
A prospective study was performed including 193 neck pain patients. Before and after treatment period, and 12 months after the start date for treatment, patients completed a questionnaire including background data and aspects of pain, function and general health. Linear multiple regression analysis was used to identify prognostic factors with the dependent variables Oswestry score and pain intensity at 12-month follow-up. Response rate 81%.
At 12-month follow-up, Oswestry score identified four prognostic factors: pain intensity; well-being; expectations of treatment; and duration of current episode. Adjusted R2 for the model was 0.32, and 20% of the patients had three of the four prognostic factors at entry, indicating risk of poor outcome. The dependent variable pain intensity revealed three prognostic factors: Oswestry score; duration of current episode; and similar problem during the previous five years. Adjusted R2 was 0.24, and 60% of the patients had two of the three prognostic factors at entry, indicating risk of poor outcome.
Different prognostic factors (with the exception of duration of current episode) were identified by the two outcome variables. Thus the results suggest that it should be taken into account whether an impairment or disability outcome is used.
确定在初级保健中接受非特异性颈部疼痛治疗的患者在一年随访时感知疼痛和功能的预后因素。
进行了一项前瞻性研究,纳入193例颈部疼痛患者。在治疗期前后以及治疗开始日期后的12个月,患者完成一份问卷,内容包括背景数据以及疼痛、功能和总体健康方面。采用线性多元回归分析来确定12个月随访时以Oswestry评分和疼痛强度为因变量的预后因素。应答率为81%。
在12个月随访时,Oswestry评分确定了四个预后因素:疼痛强度、幸福感、治疗期望和当前发作的持续时间。该模型的调整R2为0.32,20%的患者在入组时有四个预后因素中的三个,表明预后不良的风险。因变量疼痛强度显示了三个预后因素:Oswestry评分、当前发作的持续时间以及过去五年中类似问题。调整R2为0.24,60%的患者在入组时有三个预后因素中的两个,表明预后不良的风险。
两个结局变量确定了不同的预后因素(当前发作的持续时间除外)。因此,结果表明应考虑使用的是损伤还是残疾结局。