Clinical Course and Prognostic Factors of Older Patients With Back Pain and Radiating Leg Pain in General Practice: BACE Cohort Study.

IF 1.5 Q3 RHEUMATOLOGY

Musculoskeletal Care Pub Date : 2024-09-01 DOI:10.1002/msc.1937

A Khoshal Khorami, Bart W Koes, Martijn W Heymans, Wendelien H van der Gaag, Patrick J E Bindels, Alessandro Chiarotto

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引用次数: 0

Abstract

Objective: Patients with back pain (BP) and radiating leg pain have poorer clinical outcomes compared to patients with BP alone. We aimed to describe the 1-year clinical course and to identify prognostic factors associated with non-recovery in older BP patients with radiating leg pain.

Design: Patients in the BACE cohort aged >55 years with a new episode of BP and radiating leg pain were included (n = 377). Data on clinical outcomes were collected until 1-year follow-up. Uni- and multivariable regression analyses were performed to investigate the association between potential prognostic factors and three non-recovery outcomes at the 1-year follow-up.

Results: More than half of the patients (65%) did not recover after 12 months. In multivariable analyses, poor self-rated health (odds ratio [OR] 2.34, 95% CI: 1.20-4.56) and BP duration at baseline (OR 1.48, 1.12-1.96) were significantly associated with non-recovery for BP as outcome; age (OR 1.04, 1.03-1.05), smoking (OR 1.14, 1.00-1.30), depressive symptomatology (OR 1.03, 1.02-1.04), kinesiophobia (OR 1.03, 1.02-1.04), poor self-rated health (OR 2.09, 1.83-2.39), baseline disability (OR 1.16, 1.14-1.17), BP duration (OR 1.49, 1.41-1.57), leg pain (OR 1.52, 1.37-1.68), pain during rotation (OR 1.71, 1.53-1.90) and other musculoskeletal complaints (OR 1.34, 1.17-1.52) were associated with disability. No factors were associated with leg pain.

Conclusions: Several prognostic factors were associated with non-recovery in older patients with BP and radiating leg pain. Primary care clinicians should be aware of these factors in managing these patients.

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全科老年背痛和腿部放射痛患者的临床病程和预后因素：BACE队列研究

目的：与单纯背痛（BP）患者相比，背痛（BP）合并放射性腿痛患者的临床预后较差。我们旨在描述伴有放射性腿痛的老年 BP 患者 1 年的临床过程，并确定与未康复相关的预后因素：设计：纳入 BACE 队列中年龄大于 55 岁、新发血压和腿部放射痛的患者（n = 377）。临床结果数据收集至随访1年。进行了单变量和多变量回归分析，以研究潜在预后因素与随访1年的三种非康复结果之间的关联：结果：超过一半的患者（65%）在 12 个月后仍未康复。在多变量分析中，自评健康状况差（比值比 [OR] 2.34，95% CI：1.20-4.56）和基线血压持续时间（OR 1.48，1.12-1.96）与血压未恢复结果显著相关；年龄（OR 1.04，1.03-1.05）、吸烟（OR 1.14，1.00-1.30）、抑郁症状（OR 1.03，1.02-1.04）、运动恐惧症（OR 1.03，1.02-1.04）、自评健康状况差（OR 2.09，1.83-2.39）、基线残疾（OR 1.16，1.14-1.17）、血压持续时间（OR 1.49，1.41-1.57）、腿痛（OR 1.00，1.00-1.57）、腿痛（OR 1.52，1.37-1.68）、旋转时疼痛（OR 1.71，1.53-1.90）和其他肌肉骨骼不适（OR 1.34，1.17-1.52）与残疾有关。没有任何因素与腿部疼痛相关：结论：一些预后因素与患有血压和放射性腿痛的老年患者无法康复有关。初级保健临床医生在管理这些患者时应注意这些因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Musculoskeletal Care RHEUMATOLOGY-

CiteScore

2.30

自引率

7.70%

发文量

期刊介绍： Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.