Choi Hey-Ran, Song In-Ae, Oh Tak Kyu
Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul 04551, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea.
Diagnostics (Basel). 2023 Jul 28;13(15):2521. doi: 10.3390/diagnostics13152521.
This study aimed to examine the associated factors of oral glucocorticoid (GC) use in patients with chronic non-cancer pain (CNCP) associated with musculoskeletal diseases (MSDs) in South Korea. Moreover, we examined whether oral GC use was associated with long-term mortality in patients with CNCP. This population-based cohort study used data from the national registration database in South Korea. Using a stratified random sampling technique, we extracted the data from 2.5% of adult patients diagnosed with MSDs in 2010. Patients with CNCP-associated MSDs who were prescribed oral GC regularly for ≥30 days were defined as GC users, while the other patients were considered to be non-GC users. A total of 1,804,019 patients with CNCP were included in the final analysis, and 9038 (0.5%) patients were GC users, while 1,794,981 (95.5%) patients were non-GC users. Some factors (old age, comorbid status, pain medication use, and MSD) were associated with GC use among patients with CNCP. Moreover, in the multivariable time-dependent Cox regression model, GC users showed a 1.45-fold higher 10-year all-cause mortality (hazard ratio: 1.45, 95% confidence interval: 1.36-1.54; < 0.001) than non-GC users. In South Korea, the 10-year all-cause mortality risk increased in the patients with CNCP using GC.
本研究旨在调查韩国肌肉骨骼疾病（MSD）相关慢性非癌性疼痛（CNCP）患者口服糖皮质激素（GC）使用的相关因素。此外，我们还研究了口服GC的使用是否与CNCP患者的长期死亡率相关。这项基于人群的队列研究使用了韩国国家登记数据库的数据。采用分层随机抽样技术，我们从2010年诊断为MSD的成年患者中抽取了2.5%的数据。定期口服GC≥30天的CNCP相关MSD患者被定义为GC使用者，而其他患者被视为非GC使用者。最终分析共纳入1,804,019例CNCP患者，其中9038例（0.5%）为GC使用者，1,794,981例（95.5%）为非GC使用者。一些因素（老年、合并症状态、止痛药物使用和MSD）与CNCP患者的GC使用有关。此外，在多变量时间依赖性Cox回归模型中，GC使用者的10年全因死亡率比非GC使用者高1.45倍（风险比：1.45，95%置信区间：1.36 - 1.54；P < 0.001）。在韩国，使用GC的CNCP患者10年全因死亡风险增加。
