检查美国慢性疼痛与死亡率之间的关系 大人的成年人
B Michael Ray1, Kyle J Kelleran2, Jesse G Fodero3
1Department of Health & Human Sciences, Bridgewater College, Bridgewater, Virginia.
The journal of pain
|June 28, 2024
概括
慢性疼痛 (CP) 显著增加死亡风险,高影响性CP几乎使危险增加了一倍. 生活方式和心理健康因素导致疼痛患者的风险增加.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 疼痛医学 医学 疼痛医学
背景情况:
- 慢性疼痛 (CP) 影响20%的美国成年人,增加非传染性疾病的风险.
- 尽管国际数据表明死亡率更高,但CP对美国死亡率的影响仍未得到充分研究.
- 由活动限制来定义的高影响性慢性疼痛 (HICP) 代表了CP患者的重要亚组.
研究的目的:
- 调查慢性疼痛 (CP) 和高影响性慢性疼痛 (HICP) 与美国人口死亡率之间的关联.
- 量化与CP和HICP相关的过度死亡风险.
- 探索人口统计学,生活方式和心理社会因素对患有或没有CP的个体死亡率的影响.
主要方法:
- 分析国家健康访谈调查 (NHIS) 数据与国家死亡指数 (NDI) 死亡记录相关的数据.
- 在245,899,776个个体的权重样本中,使用了奇平方分析和Cox比例危险模型.
- 对CP和HICP组的死亡率和危险比率的评估,与没有疼痛的个人相比.
主要成果:
- 患有CP (20%) 和HICP (8%) 个体的死亡率明显高 (分别为5.55%和8.79%) 比没有疼痛的个体 (2.82%).
- CP与近两倍的死亡风险有关,而HICP显示风险高2.5倍.
- 对生活方式和心理社会因素的调整减少了,但没有消除死亡率升高的风险.
结论:
- 慢性疼痛和高影响性慢性疼痛是增加死亡率的重要独立风险因素.
- 生活方式因素 (吸烟,肥胖,不活动) 和心理社会变量 (抑郁,焦虑) 与CP患者的死亡率较高有关.
- 研究结果强调需要综合性疼痛管理策略,解决生活方式和心理健康问题,以减轻死亡风险.
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