Graduate School of Public Health, Seoul National University, Seoul, Korea.
Artificial Intelligence Institute, Seoul National University, Seoul, Korea.
Epidemiol Health. 2021;43:e2021058. doi: 10.4178/epih.e2021058. Epub 2021 Sep 7.
With the increasing elderly population with chronic disease, understanding pain and designing appropriate policy interventions to it have become crucial. While pain is a noted mortality risk factor, limited studies exist due to the various causes of pain and the subjectivity of pain expression. This study aimed to examine the relationship between pain and mortality, controlling for other diseases and socio-cultural factors.
We analyzed 6,258 individuals aged 45 years or older, the population with the highest prevalence of pain, using the Korean Longitudinal Study of Aging (2006-2016) data and the Cox proportional-hazards model. Further subgroup analyses were conducted by sex and education level to examine differences in the relationship between pain and mortality.
The adjusted hazard ratios of mortality were 1.16 (95% confidence interval [CI], 1.00 to 1.34, model 1) and 1.12 (95% CI, 0.97 to 1.29, model 2) for the individuals in pain depending on the models used, where additional socio-cultural factors were accounted for in model 2. For individuals in severe pain, ratios were significantly higher with 1.23 (95% CI, 1.08 to 1.41, model 1) and 1.16 (95% CI, 1.02 to 1.32, model 2). Further subgroup analyses showed that severe pain was more associated with mortality for males and more educated individuals, with adjusted hazard ratios of 1.29 (95% CI, 1.08 to 1.55, model 2) and 1.62 (95% CI, 1.15 to 2.28, model 2), respectively.
Pain showed a statistically significant relationship with mortality risk. Family members or medical staff should pay proper attention to pain, particularly severe pain in males and highly educated individuals.
随着慢性病老年人口的增加,了解疼痛并为此设计适当的政策干预措施变得至关重要。尽管疼痛是一个显著的死亡风险因素,但由于疼痛的各种原因和疼痛表达的主观性,相关研究有限。本研究旨在检查疼痛与死亡率之间的关系,同时控制其他疾病和社会文化因素。
我们使用韩国老龄化纵向研究(2006-2016 年)的数据和 Cox 比例风险模型,分析了年龄在 45 岁及以上、疼痛发生率最高的 6258 人。进一步进行了按性别和教育水平的亚组分析,以检查疼痛与死亡率之间关系的差异。
在考虑了模型 2 中的其他社会文化因素后,根据模型的不同,疼痛人群的死亡调整后风险比(HR)分别为 1.16(95%置信区间[CI],1.00 至 1.34,模型 1)和 1.12(95% CI,0.97 至 1.29,模型 2)。对于严重疼痛的个体,比值分别显著升高,分别为 1.23(95% CI,1.08 至 1.41,模型 1)和 1.16(95% CI,1.02 至 1.32,模型 2)。进一步的亚组分析表明,严重疼痛与男性和受教育程度较高的个体的死亡率相关性更强,调整后的 HR 分别为 1.29(95% CI,1.08 至 1.55,模型 2)和 1.62(95% CI,1.15 至 2.28,模型 2)。
疼痛与死亡风险呈统计学显著相关。家庭成员或医务人员应适当关注疼痛,特别是男性和高学历人群的严重疼痛。