Latina Roberto, De Marinis Maria Grazia, Giordano Felice, Osborn John Frederick, Giannarelli Diana, Di Biagio Ettore, Varrassi Giustino, Sansoni Julita, Bertini Laura, Baglio Giovanni, D'Angelo Daniela, Baldeschi Gianni Colini, Piredda Michela, Carassiti Massimiliano, Camilloni Arianna, Paladini Antonella, Casale Giuseppe, Mastroianni Chiara, Notaro Paolo, Diamanti Paolo, Coaccioli Stefano, Tarsitani Gianfranco, Cattaruzza Maria Sofia
Sapienza University, Rome, Italy.
Campo Bio-Medico University, Rome, Italy.
Pain Manag Nurs. 2019 Aug;20(4):373-381. doi: 10.1016/j.pmn.2019.01.005. Epub 2019 May 15.
In Italy, chronic pain affects more than a quarter of the population, whereas the average European prevalence is 21%. This high prevalence might be due to the high percentage of Italian people who do not receive treatment, even after the passing of law 38/2010 (the right to access pain management in Italy), which created a regional network for the diagnosis and treatment of noncancer chronic pain. Italian epidemiologic studies on chronic pain are scanty, and this observational, multicenter, cross-sectional study is the first to investigate the clinical characteristics of patients who attended the pain management clinics in the Latium Region, Italy, for the management of their noncancer chronic pain. A total of 1,606 patients (mean age 56.8 years, standard deviation ± 11.4), 67% women, were analyzed. Severe pain was present in 54% of the sample. Women experienced pain and had it in two or more sites more often than men (57% vs. 50%, p = .02; and 55.2% vs. 45.9%, p < .001, respectively). Chronic pain was musculoskeletal (45%), mixed (34%), and neuropathic (21%). In more than 60% of the cases, chronic pain was continuous, and in 20% it had lasted for more than 48 months; long-lasting pain was often neuropathic. Low back (33.4%) and lower limbs (28.2%) were the main locations. Severe intensity of pain was statistically significantly associated with female gender (odds ratio [OR] 1.39; 95% confidence interval [CI] 1.06-1.84); with International Classification of Diseases, Ninth Revision, codes for chronic pain syndrome (OR 2.14; 95% CI 1.55-2.95); and with continuous pain (OR 2.02; 95% CI 1.54-2.66). Neuropathic pain and mixed pain were significantly associated with number of sites, and a trend seemed to be present (OR 2.11 and 3.02 for 2 and 3 + sites; 95% CI 1.59-2.79 and 2.00-4.55, respectively).
在意大利,慢性疼痛影响着超过四分之一的人口,而欧洲的平均患病率为21%。这种高患病率可能是由于即使在第38/2010号法律(意大利获得疼痛管理的权利)通过后,仍有很大比例的意大利人未接受治疗,该法律创建了一个用于诊断和治疗非癌性慢性疼痛的区域网络。意大利关于慢性疼痛的流行病学研究很少,而这项观察性、多中心、横断面研究是首次调查在意大利拉齐奥地区的疼痛管理诊所就诊以治疗其非癌性慢性疼痛的患者的临床特征。总共分析了1606名患者(平均年龄56.8岁,标准差±11.4),其中67%为女性。样本中有54%存在重度疼痛。女性比男性更常经历疼痛且疼痛部位在两个或更多处(分别为57%对50%,p = 0.02;以及55.2%对45.9%,p < 0.001)。慢性疼痛为肌肉骨骼性的占45%,混合型的占34%,神经性的占21%。在超过60%的病例中,慢性疼痛是持续性的,20%的病例疼痛持续超过48个月;长期疼痛通常是神经性的。下背部(33.4%)和下肢(28.2%)是主要疼痛部位。疼痛的严重程度在统计学上与女性性别显著相关(优势比[OR]1.39;95%置信区间[CI]1.06 - 1.84);与《国际疾病分类》第九版慢性疼痛综合征编码相关(OR 2.14;95% CI 1.55 - 2.95);以及与持续性疼痛相关(OR 2.02;95% CI 1.54 - 2.66)。神经性疼痛和混合型疼痛与疼痛部位数量显著相关,且似乎存在一种趋势(2个和≥3个疼痛部位的OR分别为2.11和3.02;95% CI分别为1.59 - 2.79和2.00 - 4.55)。
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