Steenstra I A, Verbeek J H, Heymans M W, Bongers P M
Institute for Research in Extramural Medicine and Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands.
Occup Environ Med. 2005 Dec;62(12):851-60. doi: 10.1136/oem.2004.015842.
The percentages of patients with acute low back pain (LBP) that go on to a chronic state varies between studies from 2% to 34%. In some of these cases low back pain leads to great costs.
To evaluate the evidence for prognostic factors for return to work among workers sick listed with acute LBP.
Systematic literature search with a quality assessment of studies, assessment of levels of evidence for all factors, and pooling of effect sizes.
Inclusion of studies in the review was restricted to inception cohort studies of workers with LBP on sick leave for less than six weeks, with the outcome measured in absolute terms, relative terms, survival curve, or duration of sick leave. Of the studies, 18 publications (14 cohorts) fulfilled all inclusion criteria. One low quality study, four moderate quality studies, and nine high quality studies were identified; 79 prognostic factors were studied and grouped in eight categories for which the evidence was assessed.
Specific LBP, higher disability levels, older age, female gender, more social dysfunction and more social isolation, heavier work, and receiving higher compensation were identified as predictors for a longer duration of sick leave. A history of LBP, job satisfaction, educational level, marital status, number of dependants, smoking, working more than 8 hour shifts, occupation, and size of industry or company do not influence duration of sick leave due to LBP. Many different constructs were measured to identify psychosocial predictors of long term sick leave, which made it impossible to determine the role of these factors.
急性下背痛（LBP）患者发展为慢性状态的比例在不同研究中有所不同，从2%到34%不等。在其中一些病例中，下背痛会导致巨大的成本。
评估急性LBP病假工人恢复工作的预后因素的证据。
进行系统的文献检索，对研究进行质量评估，评估所有因素的证据水平，并汇总效应量。
纳入综述的研究仅限于对病假少于六周的LBP工人的起始队列研究，结果以绝对、相对、生存曲线或病假持续时间来衡量。在这些研究中，18篇出版物（14个队列）符合所有纳入标准。确定了1项低质量研究、4项中等质量研究和9项高质量研究；研究了79个预后因素，并将其分为八类，对这些因素的证据进行了评估。
特定的下背痛、更高的残疾水平、年龄较大、女性、更多的社会功能障碍和更多的社会隔离、工作更繁重以及获得更高的补偿被确定为病假持续时间更长的预测因素。下背痛病史、工作满意度、教育水平、婚姻状况、受抚养人数、吸烟、轮班工作超过8小时、职业以及行业或公司规模不会影响因下背痛导致的病假持续时间。为了确定长期病假的心理社会预测因素，测量了许多不同的结构，这使得无法确定这些因素的作用。
