Xiao Huang, Darui Gao, Mengmeng Ji, Yanyu Zhang, Yiwen Dai, Yang Pan, Yuling Liu, Anshi Wu, Fanfan Zheng, Wuxiang Xie
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引用次数: 0
Abstract
Study objective: Chronic pain (CP) has been linked to multiple health complications, but its association with venous thromboembolism (VTE) remains unclear. We aimed to investigate the associations between CP and VTE risk, and the potential mediating role of 24-h movement behaviors.
Design: A prospective cohort study.
Setting: Population-based study using data from the UK Biobank.
Interventions: Not applicable; this was an observational study analyzing exposure to CP.
Measurements: CP was assessed as the main exposure, and incident VTE as the primary outcome. Exploratory analyses were conducted to examine the role of 24-h movement behaviors, including sedentary behavior (SB), light-intensity physical activity (LIPA), moderate-to-vigorous physical activity (MVPA), and sleep, in relation to CP and VTE. Multivariate-adjusted Cox proportional hazards regression, compositional mediation analysis, and isotemporal substitution Cox regression were applied to evaluate these associations.
Participants: A total of 453,289 individuals were included in the analytic cohort, with 88,675 participants in the accelerometer sub-cohort for analyses of movement behaviors.
Main results: Compared to the pain-free group, participants with limited chronic pain (LCP, HR: 1.13, 95% CI: 1.08-1.19, P < 0.001) and multisite chronic pain (MCP, HR: 1.32, 95% CI: 1.24-1.41, P < 0.001) showed increased VTE risk in the total cohort. In exploratory analyses within the accelerometer sub-cohort, 24-h movement behaviors showed a contribution to the MCP-VTE association (indirect effect HR = 1.03 [1.01-1.05]; total effect HR = 1.25 [1.02-1.48]; 12.8% mediated). Among MCP participants, hypothetical reallocation models suggested that reallocating one hour/day from sleep to LIPA (HR = 0.87, 95% CI: 0.76-0.99) or MVPA (HR = 0.59, 95% CI: 0.35-0.98) was associated with lower VTE risk.
Conclusions: CP was associated with an increased risk of VTE. In participants with MCP, 24-h movement behaviors showed a potential association that may contribute to this relationship. However, these findings are exploratory and do not support causal or prescriptive interpretation.
期刊介绍：
The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained.
The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.
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