Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14623, USA.
Spine (Phila Pa 1976). 2012 Sep 15;37(20):E1282-9. doi: 10.1097/BRS.0b013e318265a930.
A retrospective cohort study.
To evaluate return-to-work outcomes in patients with chronic, work-related low back pain referred to pain treatment centers and/or spine clinics (PTCs/SCs).
Return-to-work outcomes in cases of work-related chronic low back pain after referral to PTCs and/or SCs have not been previously studied.
A retrospective chart review of 230 consecutive patients was conducted from an occupational medicine program. Of these, 122 patients were referred to a PTC/SC and 108 patients were not. Multivariate logistic regression was used to develop a model to predict improvement in functional status and pain level after 1 year.
At the 1-year evaluation, there was functional improvement in the nonreferral group (P < 0.001) and no change in the referral group (P = 0.21). The change in pain level was similar. Time from injury to initial evaluation seemed to be the major factor contributing to poor outcomes in both groups.
Referral to a PTC/SC did not yield improved functional outcomes in this cohort. A major factor contributing to this finding was the length of time to referral to PTC/SC after the initial injury.
回顾性队列研究。
评估慢性、与工作相关的下腰痛患者在转诊至疼痛治疗中心和/或脊柱诊所(PTC/SC)后的工作恢复情况。
之前尚未研究过 PTC/SC 转诊后与工作相关的慢性下腰痛患者的工作恢复情况。
对来自职业医学项目的 230 例连续患者进行了回顾性图表审查。其中,122 例患者转诊至 PTC/SC,108 例患者未转诊。采用多变量逻辑回归建立模型,以预测 1 年后功能状态和疼痛水平的改善情况。
在 1 年评估时,非转诊组的功能有改善(P<0.001),而转诊组没有变化(P=0.21)。疼痛水平的变化也相似。两组的不良结局都与受伤后首次评估到接受 PTC/SC 治疗的时间间隔较长有关。
在本队列中,转诊至 PTC/SC 并未改善功能结果。造成这种结果的一个主要因素是从初始损伤到接受 PTC/SC 治疗的时间间隔较长。