Huang Yilong, Li Chunli, Chen Jiaxin, Jiang Yuanming, Yang Yingjuan, Yang Juntao, Wang Zhongwei, Zhao Derong, Luo Mingbin, Pu Fushun, Zhang Zhenguang, He Bo
Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of Radiology, Dali Bai Autonomous Prefecture People's Hospital, Dali, China.
Front Med (Lausanne). 2023 Jun 26;10:1194521. doi: 10.3389/fmed.2023.1194521. eCollection 2023.
Approximately 40% of patients with acute low back pain (LBP) develop chronic low back pain, which significantly increases the risk of poor prognosis. To reduce the risk of acute LBP becoming chronic, effective preventive strategies are needed. Early identification of risk factors for the development of chronic LBP can help clinicians choose appropriate treatment options and improve patient outcomes. However, previous screening tools have not considered medical imaging findings. The aim of this study is to identify factors that can predict the risk of acute LBP becoming chronic based on clinical information, pain and disability assessment, and MRI imaging findings. This protocol describes the methodology and plan for investigating multidimensional risk factors for acute LBP becoming chronic, in order to better understand the development of acute LBP and prevent chronic LBP.
This is a prospective multicenter study. We plan to recruit 1,000 adult patients with acute low back pain from four centers. In order to select four representative centers, we find the larger hospitals from different regions in Yunnan Province. The study will use a longitudinal cohort design. Patients will undergo baseline assessments upon admission and will be followed up for 5 years to collect the time of chronicity and associated risk factors. Upon admission, patients will be collected detailed demographic information, subjective and objective pain scores, disability scale, and lumbar spine MRI scanning. In addition, patient's medical history, lifestyle, psychological factors will be collected. Patients will be followed up at 3 months, 6 months, 1 year, 2 years and up for 5 years after admission to collect the time of chronicity and associated factors. Multivariate analysis will be used to explore the multidimensional risk factors affecting the chronicity of acute LBP patients (such as age, gender, BMI, degree of intervertebral disc degeneration, etc.), and survival analysis will be performed to explore the impact of each factor on the time of chronicity.
The study has been approved by the institutional research ethics committee of each study center (main center number: 2022-L-305). Results will be disseminated through scientific conferences and peer-reviewed publications, as well as meetings with stakeholders.
约40%的急性腰痛（LBP）患者会发展为慢性腰痛，这显著增加了预后不良的风险。为降低急性LBP转变为慢性的风险，需要有效的预防策略。早期识别慢性LBP发生的风险因素有助于临床医生选择合适的治疗方案并改善患者预后。然而，以往的筛查工具未考虑医学影像检查结果。本研究的目的是基于临床信息、疼痛和残疾评估以及MRI影像检查结果，识别可预测急性LBP转变为慢性风险的因素。本方案描述了调查急性LBP转变为慢性的多维风险因素的方法和计划，以便更好地了解急性LBP的发展并预防慢性LBP。
这是一项前瞻性多中心研究。我们计划从四个中心招募1000名成年急性腰痛患者。为选择四个有代表性的中心，我们在云南省不同地区寻找较大的医院。本研究将采用纵向队列设计。患者入院时将接受基线评估，并将随访5年以收集慢性化时间及相关风险因素。入院时，将收集患者详细的人口统计学信息、主观和客观疼痛评分、残疾量表以及腰椎MRI扫描结果。此外，还将收集患者的病史、生活方式、心理因素。患者将在入院后3个月、6个月、1年、2年直至5年进行随访，以收集慢性化时间及相关因素。将采用多变量分析来探索影响急性LBP患者慢性化（如年龄、性别、体重指数、椎间盘退变程度等）的多维风险因素，并进行生存分析以探索各因素对慢性化时间的影响。
本研究已获得各研究中心的机构研究伦理委员会批准（主要中心编号：2022-L-305）。研究结果将通过科学会议、同行评审出版物以及与利益相关者的会议进行传播。
