McClish Donna, Okhomina Victoria, Pascale Angela, Valrie Cecelia, Sisler India, Villella Anthony, Smith Wally
Departments of Biostatistics and.
Psychology, Virginia Commonwealth University, Richmond, VA, United States.
Pain. 2024 Jan 1;165(1):135-143. doi: 10.1097/j.pain.0000000000003011. Epub 2023 Aug 11.
In a cross-sectional analysis of baseline data from a randomized clinical trial, we studied 198 adolescents and adults aged 15+ with sickle cell disease. Interest was in assessing the relative strengths of the relationship of vaso-occlusive crisis (VOC) pain domains of intensity, frequency, and duration, with health-related quality of life (HRQOL). Variation in psychosocial, physical function, and pain expression domains of HRQOL was partially explained by frequency, intensity, and duration of VOC pain, separately and together, over and above differences in age, sex, genotype, and organ system damage. However, no single domain measure accounted for more than an additional partial R2 of 12.5% alone. Vaso-occlusive crisis pain frequency explained the most variation, when simultaneously considering VOC intensity and duration, except for stiffness , where duration was most predictive. Yet VOC pain intensity, and even VOC duration, also contributed to variability in HRQOL. We recommend that for most purposes, because all 3 VOC pain domains contribute to variability in HRQOL, all 3 domains should be assessed and interventions should be targeted to improve all 3 domains to maximize HRQOL outcomes (Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02197845 ).
在一项对随机临床试验基线数据的横断面分析中，我们研究了198名年龄在15岁及以上的镰状细胞病青少年和成年人。我们感兴趣的是评估血管闭塞性危机（VOC）疼痛在强度、频率和持续时间方面与健康相关生活质量（HRQOL）之间关系的相对强度。HRQOL在心理社会、身体功能和疼痛表达方面的差异，部分是由VOC疼痛的频率、强度和持续时间单独或共同解释的，这超出了年龄、性别、基因型和器官系统损伤的差异。然而，没有任何一个单一领域的测量指标单独解释的额外部分R2超过12.5%。在同时考虑VOC强度和持续时间时，除了僵硬方面持续时间最具预测性外，血管闭塞性危机疼痛频率解释的差异最大。然而，VOC疼痛强度，甚至VOC持续时间，也对HRQOL的变异性有影响。我们建议，在大多数情况下，由于所有3个VOC疼痛领域都对HRQOL的变异性有影响，因此应该评估所有3个领域，并且干预措施应旨在改善所有3个领域，以最大限度地提高HRQOL结果（临床试验注册：ClinicalTrials.gov标识符：NCT02197845）。
