Parinder Astrid, Lyckegård Finn Ellen, Dahlin Lars B, Nyman Erika
Department of Translational Medicine - Hand Surgery, Lund University, Malmö, Sweden.
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
PLoS One. 2025 Mar 28;20(3):e0320263. doi: 10.1371/journal.pone.0320263. eCollection 2025.
The pathophysiology behind Complex Regional Pain Syndrome (CRPS) is not fully understood and associated factors and triggers for developing the condition are debated. We aimed to study such factors and long-term outcome in a descriptive cross-sectional study with a well-defined population with CRPS in the upper limb and related to sex and CRPS type. In retrospectively collected data from medical records, 149 subjects [women n = 104 (70%); type 1 CRPS, n = 108 (72%); type 2 CRPS, n = 41 (28%); follow-up time 21 [8-43] months] were identified and analysed (Chi-squared test, Mann-Whitney U-test, and multiple linear regression). A majority were manual workers, and a larger proportion of subjects were smokers and had less post-secondary education than a reference population (p < 0.001 and p < 0.008). Men were younger, more frequently smoked, had higher BMI, and had lower education levels than women (p = 0.044, p = 0.007, p < 0.001, and p = 0.016, respectively). Subjects with CRPS type 2 were younger and had a longer time from symptoms until diagnosis, longer follow-up time, and more follow-up visits, indicating worse outcome (p = 0.016, p = 0.0012, p = 0.003, and p = 0.004, respectively). Among CRPS, 32% had a prior pain disorder and 7% had previously visited a pain management clinic. While there was no significant difference in mental illness occurrence before CRPS diagnosis compared to a reference population, mental illness increased by 76% after diagnosis. Factors such as CRPS type 2, older age, and delayed diagnosis were associated with longer follow-up periods. Additionally, 45% were on sick leave for over 12 months, and 20% were permanently unable to work. Socioeconomic deprivation is an associated factor in developing CRPS, in which a variety of triggers exist. Subjects with CRPS, particularly type 2, are at high risk of severe remaining symptoms, including mental illness and risk of never returning to work.
复杂区域疼痛综合征（CRPS）背后的病理生理学尚未完全明确，关于引发该病症的相关因素和触发因素仍存在争议。我们旨在通过一项描述性横断面研究，对上肢患有CRPS的明确人群进行研究，探讨这些因素及长期预后情况，并分析其与性别和CRPS类型的关系。在回顾性收集的病历数据中，共识别并分析了149名受试者[女性n = 104（70%）；1型CRPS，n = 108（72%）；2型CRPS，n = 41（28%）；随访时间21 [8 - 43]个月]（采用卡方检验、曼-惠特尼U检验和多元线性回归分析）。大部分受试者为体力劳动者，与参照人群相比，吸烟的受试者比例更高，接受高等教育的比例更低（p < 0.001和p < 0.008）。男性比女性更年轻，吸烟更频繁，体重指数更高，教育水平更低（分别为p = 0.044、p = 0.007、p < 0.001和p = 0.016）。2型CRPS受试者更年轻，从出现症状到确诊的时间更长，随访时间更长，随访次数更多，表明预后更差（分别为p = 0.016、p = 0.0012、p = 0.003和p = 0.004）。在CRPS患者中，32%曾患有疼痛性疾病，7%曾就诊于疼痛管理诊所。虽然与参照人群相比，CRPS诊断前精神疾病的发生率无显著差异，但诊断后精神疾病增加了76%。2型CRPS、年龄较大和诊断延迟等因素与较长的随访期相关。此外，45%的人病假超过12个月，20%的人永久无法工作。社会经济剥夺是CRPS发病的一个相关因素，其中存在多种触发因素。CRPS患者，尤其是2型患者，存在严重残留症状的高风险，包括精神疾病和无法重返工作岗位的风险。
