Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cadiz, Spain.
Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cadiz, Spain.
Qual Life Res. 2020 Nov;29(11):2935-2947. doi: 10.1007/s11136-020-02553-y. Epub 2020 Jun 16.
To estimate the prevalence of diagnosed and undiagnosed chronic low back pain (CLBP-D and CLBP-UD, respectively) in the general adult population in Spain and to compare the characteristics of these two groups with subjects without CLBP symptoms (No-CLBP). To establish CLBP-D patient sub-groups according to their self-perceived health status, mental health, level of pain and the impact of their pain on daily activities.
Data were obtained from the National Health Survey of Spain 2017 with a sample of 23,089 adults. Three groups were defined: CLBP-D, CLBP-UD and No-CLBP. In the CLBP-D group, a cluster analysis was performed to identify sub-groups. A multinomial regression model was constructed to determine the factors associated with each of the sub-groups identified.
The prevalence of CLBP-D was 22% (95% CI 21.5-22.5) and that of CLBP-UD was 1.4% (95% CI 1.2-1.5). CLBP-D was more common in middle-aged females with a low educational level. They have a worse perceived health status, report more comorbidities, have worse mental health and more limitations in comparison with the populations without CLBP and with CLBP-UD. Three sub-groups of CLBP-D subjects were identified. Women and older subjects with a lower educational level, more occupational stress, less social support and with more physical limitations were the most likely subjects to be included in the group worst-affected.
There is a high prevalence of CLBP among the adult population in Spain. Occupational stress and a lack of social support are common factors among subjects' worst-affected of CLBP-D and identifying the subjects with these risks is therefore a recommended strategy for improving the healthcare provided to CLBP patients.
估计西班牙普通成年人群中诊断和未诊断的慢性下背痛（分别为 CLBP-D 和 CLBP-UD）的患病率，并比较这两组与无 CLBP 症状的受试者（无 CLBP）的特征。根据患者自我感知的健康状况、心理健康、疼痛程度以及疼痛对日常活动的影响，为 CLBP-D 患者建立亚组。
数据来自 2017 年西班牙国家健康调查，样本量为 23089 名成年人。定义了三组：CLBP-D、CLBP-UD 和无 CLBP。在 CLBP-D 组中，进行了聚类分析以确定亚组。构建了一个多项回归模型，以确定与每个识别出的亚组相关的因素。
CLBP-D 的患病率为 22%（95%CI 21.5-22.5），CLBP-UD 的患病率为 1.4%（95%CI 1.2-1.5）。CLBP-D 在中年女性和受教育程度较低的人群中更为常见。与无 CLBP 和 CLBP-UD 的人群相比，他们的自我感知健康状况更差，报告更多的合并症，心理健康状况更差，活动受限更多。确定了 CLBP-D 患者的三个亚组。女性和教育程度较低、职业压力较大、社会支持较少、身体限制较多的老年患者最有可能被纳入病情最严重的组。
西班牙成年人群中 CLBP 的患病率较高。职业压力和缺乏社会支持是 CLBP-D 患者中病情最严重者的常见因素，因此识别出具有这些风险的患者是改善 CLBP 患者医疗服务的推荐策略。
