School of Health and Society, Kristianstad University College, Kristianstad, Sweden.
Disabil Rehabil. 2009;31(24):1980-7. doi: 10.3109/09638280902874154.
Widespread chronic pain has been related to disability and loss of quality of life, but in a few epidemiological studies also to increased mortality. The aim of this study was to further investigate the relationship between chronic pain, lifestyle factors and all cause mortality.
A random sample of an adult (age 25-74) Swedish population (n = 1609) responded to a comprehensive questionnaire on pain, other symptoms, lifestyle, work and socioeconomic factors in 1988. Mortality data for this cohort between 1988 and 2002 were analysed. Survival analysis (Kaplan-Meier) and Cox proportional regression were used to study initially reported factors influencing survival.
Individuals with widespread chronic pain showed an increased mortality risk (hazard ratio, HR = 1.95, CI: 1.26-3.03) compared to the group without chronic pain. Death due to cardiovascular disease accounted for the increased mortality. Adjustment for lifestyle factors eliminated the excess risk.
Increased mortality among individuals with widespread chronic pain is related to factors like smoking, sleep disturbances and low physical activity. The result emphasises the importance of including lifestyle factors in a cognitive-behavioural rehabilitation process. It remains to be shown whether health promotion activities aimed at lifestyle could change mortality among individuals with chronic pain.
广泛的慢性疼痛与残疾和生活质量下降有关，但在一些流行病学研究中也与死亡率增加有关。本研究旨在进一步探讨慢性疼痛、生活方式因素与全因死亡率之间的关系。
1988 年，对瑞典成年人（25-74 岁）进行了一项关于疼痛、其他症状、生活方式、工作和社会经济因素的综合问卷调查，随机抽取了 1609 名成年人作为样本。对该队列在 1988 年至 2002 年间的死亡率数据进行了分析。采用生存分析（Kaplan-Meier）和 Cox 比例回归分析来研究最初报告的影响生存的因素。
与无慢性疼痛的人群相比，患有广泛慢性疼痛的个体的死亡风险增加（风险比，HR=1.95，95%置信区间：1.26-3.03）。心血管疾病导致的死亡占增加的死亡人数。调整生活方式因素后，风险增加得到消除。
广泛的慢性疼痛患者的死亡率增加与吸烟、睡眠障碍和低身体活动等因素有关。这一结果强调了在认知行为康复过程中纳入生活方式因素的重要性。尚需进一步研究针对生活方式的健康促进活动是否可以改变慢性疼痛患者的死亡率。
