慢性疼痛和死亡率之间的关系是因果关系吗? 一个倾向性评分分析分析
Eva Ryan1, Hanna Grol-Prokopczyk2, Christopher R Dennison2
1Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland.
Pain
|July 9, 2024
概括
慢性疼痛与增加的死亡率有关,但混因素显著影响了这一关联. 经过调整后,疼痛对死亡的因果作用是适度的,突出显示了可修改的风险因素的作用.
科学领域:
- 老年学和流行病学.
- 公共卫生和疼痛研究研究
背景情况:
- 慢性疼痛是一种广泛的疾病,影响生活质量.
- 慢性疼痛和死亡率之间的因果关系仍然不确定.
研究的目的:
- 研究慢性疼痛对死亡率的因果关系.
- 用一个大,纵向队列来分析疼痛与死亡率的关系.
主要方法:
- 利用了来自美国健康和退休研究的19,971名老年人 (51岁以上) 的数据.
- 员工倾向得分匹配和反向概率权重使用Cox比例危险模型.
- 作为20年随访期间的暴露,检查了慢性疼痛 (中度或重度).
主要成果:
- 未经调整的分析显示,慢性疼痛与死亡率之间存在很强的关联 (HR: 1.32).
- 经过调整后的分析显示了较为温和的因果作用 (死亡风险增加5%-9%),一些结果与没有因果作用相容.
- 将抑郁症状作为调解者的模型表明了适度的因果关系 (HR:1.08).
结论:
- 混变量显著影响观察到的疼痛死亡率相关性.
- 慢性疼痛对死亡率的直接因果关系似乎很小.
- 需要进一步研究反循环和慢性疼痛对死亡率的累积影响.
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