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Widespread body pain and mortality: prospective population based study

机译:广泛的身体疼痛和死亡率:基于前瞻性人群的研究

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Objective To determine whether there is excess mortality in groups of people who report widespread body pain, and if so to establish the nature and extent of any excess. Design Prospective follow up study over eight years. Mortality rate ratios were adjusted for age group, sex, and study location. Setting North west England. Participants 6569 people who took part in two pain surveys during 1991-2. Main outcome measures Pain status at baseline and subsequent mortality. Results 1005 (15%) participants had widespread pain, 3176 (48%) had regional pain, and 2388 (36%) had no pain. During follow up mortality was higher in people with regional pain (mortality rate ratio 1.21, 95% confidence interval 1.01 to 1.44) and widespread pain (1.31,1.05 to 1.65) than in those who reported no pain. The excess mortality among people with regional and widespread pain was almost entirely related to deaths from cancer (1.55 (1.09 to 2.19) for regional pain and 2.07 (1.37 to 3.13) for widespread pain). The excess cancer mortality remained after exclusion of people in whom cancer had been diagnosed before the original survey and after adjustment for potential confounding factors. There were also more deaths from causes other than disease (for example, accidents, suicide, violence) among people with widespread pain (5.21, 0.94 to 28.78). Conclusion There is an intriguing association between the report of widespread pain and subsequent death from cancer in the medium and long term. This may have implications for the long term follow up of patients with "unexplained" widespread pain symptoms, such as those with fibromyalgia.
机译:目的确定在报告广泛的身体疼痛的人群中是否存在过高的死亡率,如果是,则确定任何过高的死亡率的性质和程度。八年的设计前瞻性跟进研究。根据年龄组,性别和研究地点对死亡率比率进行了调整。设置英格兰西北部。参与者6569人在1991-2年期间参加了两次疼痛调查。主要结局指标是基线时的疼痛状态和随后的死亡率。结果1005(15%)名参与者有广泛的疼痛,3176名(48%)有区域性疼痛,2388(36%)没有疼痛。在随访期间,有局部疼痛(死亡率比为1.21,95%置信区间为1.01至1.44)和广泛疼痛(1.31,1.05至1.65)的人的死亡率高于没有疼痛的人。患有局部疼痛和广泛性疼痛的人的过高死亡率几乎完全与癌症死亡有关(局部疼痛为1.55(1.09至2.19),广泛性疼痛为2.07(1.37至3.13))。在原始调查之前和对潜在的混杂因素进行调整之后,排除了被诊断出患有癌症的人之后,癌症的剩余死亡率仍然很高。在广泛疼痛的人群中,除疾病(例如事故,自杀,暴力)以外的其他原因造成的死亡人数也更多(5.21,0.94至28.78)。结论在中长期,广泛的疼痛报告与随后的癌症死亡报告之间存在着有趣的联系。这可能对具有“无法解释的”广泛疼痛症状的患者(如纤维肌痛患者)的长期随访产生影响。

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