Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN 55905,USA.
Pain Med. 2009 Nov;10(8):1416-25. doi: 10.1111/j.1526-4637.2009.00702.x. Epub 2009 Sep 1.
The primary aim of this study was to determine the influence of sex and the interactions between sex and smoking status on the immediate treatment outcomes of patients undergoing multidisciplinary pain treatment.
A retrospective, repeated measures design. Setting. Multidisciplinary pain rehabilitation center at a tertiary referral medical center.
The cohort (N = 1,241) included 928 women and 313 men of whom 313 were current smokers, 294 were former smokers and 634 were never smokers consecutively admitted from September 2003 through February 2007. Interventions. A 3-week outpatient multidisciplinary pain rehabilitation program.
The Multidimensional Pain Inventory, Short Form-36 Health Status Questionnaire, Center for Epidemiologic Studies-Depression scale, Pain Anxiety Symptom Scale, and Pain Catastrophizing Scale were administered at admission and dismissal.
Women experienced significantly greater improvement in depressive symptoms compared with men (P = 0.023). Smokers experienced significantly greater improvements in depression (P = 0.039), pain catastrophizing (P = 0.010), and anxiety (P = 0.037) compared with former and never smokers. No significant interaction effects between treatment by sex by smoking status were observed. A significant sex by smoking status interaction was observed for daily morphine equivalent dose (mg/d) where male smokers consumed greater quantities of opioids compared with female smokers at program admission (P < 0.001).
The effects of smoking status on the immediate treatment outcomes of multidisciplinary pain treatment are not modified by sex. However, women experienced significantly greater improvement in depression than men and male smokers consumed significantly greater quantities of opioids compared with female smokers at admission.
本研究的主要目的是确定性别以及性别与吸烟状况之间的相互作用对接受多学科疼痛治疗的患者即刻治疗结果的影响。
回顾性、重复测量设计。地点：三级转诊医疗中心的多学科疼痛康复中心。
该队列（N=1241）包括 928 名女性和 313 名男性，其中 313 名是现吸烟者，294 名是前吸烟者，634 名是从不吸烟者，他们于 2003 年 9 月至 2007 年 2 月连续入院。干预措施：为期 3 周的门诊多学科疼痛康复计划。
与男性相比，女性在抑郁症状方面的改善更为显著（P=0.023）。与前吸烟者和从不吸烟者相比，吸烟者在抑郁（P=0.039）、疼痛灾难化（P=0.010）和焦虑（P=0.037）方面的改善更为显著。治疗效果在性别和吸烟状况之间未观察到显著的交互作用。在每日吗啡等效剂量（mg/d）方面观察到性别和吸烟状况的显著交互作用，即在项目开始时，男性吸烟者比女性吸烟者摄入更多的阿片类药物（P<0.001）。
吸烟状况对多学科疼痛治疗即刻治疗结果的影响不受性别影响。然而，与男性相比，女性在抑郁方面的改善更为显著，而且在入院时，男性吸烟者比女性吸烟者摄入的阿片类药物明显更多。
