Machado Gustavo C, Maher Chris G, Ferreira Paulo H, Latimer Jane, Koes Bart W, Steffens Daniel, Ferreira Manuela L
School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, Camperdown, NSW 2050 Australia.
School of Public Health, The University of Sydney, Sydney, Australia.
Phys Ther. 2017 Sep 1;97(9):889-895. doi: 10.1093/ptj/pzx067.
Although recurrence is common after an acute episode of low back pain, estimates of recurrence rates vary widely and predictors of recurrence remain largely unknown.
The purposes of the study were to determine the 1-year incidence of recurrence in participants who recovered from an acute episode of low back pain and to identify predictors of recurrence.
The design was an inception cohort study nested in a case-crossover study.
For 12 months, 832 of the 999 participants who initially presented to primary care within the first 7 days of an episode of low back pain were followed. Of these participants, 469 recovered (1 month pain free) from the index episode within 6 weeks and were included in this study. Recurrence was defined as a new episode lasting more than 1 day, or as an episode of care seeking. Putative predictors were assessed at baseline and chosen a priori. Multivariable regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI).
The 1-year incidence of recurrence of low back pain was 33%, and the 1-year incidence of recurrence of low back pain with care seeking was 18%. Participants reporting more than 2 previous episodes of low back pain had increased odds of future recurrences (OR = 3.18, CI = 2.11-4.78). This factor was also associated with recurrent episodes that led to care seeking (OR = 2.87, CI = 1.73-4.78). No other factors were associated with recurrences.
There are limitations inherent in reliance on recall.
After an acute episode of low back pain, one-third of patients will experience a recurrent episode, and approximately half of those will seek care. Experiencing more than 2 previous episodes of low back pain triples the odds of a recurrence within 1 year.
尽管急性下腰痛发作后复发很常见，但复发率的估计差异很大，复发的预测因素在很大程度上仍然未知。
本研究的目的是确定从急性下腰痛发作中恢复的参与者的1年复发率，并确定复发的预测因素。
该设计是一项嵌套在病例交叉研究中的起始队列研究。
在12个月内，对最初在腰痛发作的前7天内到初级保健机构就诊的999名参与者中的832名进行了随访。在这些参与者中，469名在6周内从首次发作中康复（1个月无疼痛）并被纳入本研究。复发被定义为持续超过1天的新发作，或寻求治疗的发作。在基线时评估假定的预测因素，并事先选择。多变量回归分析用于计算比值比（OR）和95%置信区间（CI）。
下腰痛的1年复发率为33%，因下腰痛寻求治疗的1年复发率为18%。报告有2次以上既往下腰痛发作的参与者未来复发的几率增加（OR = 3.18，CI = 2.11 - 4.78）。该因素也与导致寻求治疗的复发发作相关（OR = 2.87，CI = 1.73 - 4.78）。没有其他因素与复发相关。
依赖回忆存在固有的局限性。
急性下腰痛发作后，三分之一的患者会经历复发发作，其中约一半会寻求治疗。既往经历过2次以上下腰痛发作会使1年内复发的几率增加两倍。
