Junpeng Yuan, Youjia Yu, Hong Liu, Huichan Xu, Yan Li, Xiaohong Jin
{"title":"接受介入疼痛治疗的带状疱疹相关神经痛患者预后不良的风险因素。","authors":"Junpeng Yuan, Youjia Yu, Hong Liu, Huichan Xu, Yan Li, Xiaohong Jin","doi":"10.3389/fnmol.2024.1393219","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Zoster-associated neuralgia (ZAN) is recognized as a challenging neuralgia that often leads to poor prognosis in patients receiving interventional pain management. Identifying risk factors early can enable clinicians to develop personalized treatment plans; however, research in this area is limited.</p><p><strong>Methods: </strong>We retrospectively screened all patients with ZAN who received interventional therapy in the Pain Department of Soochow University First Affiliated Hospital from January 1, 2022 to August 31, 2023. Data on patient demographics, medical history, neutrophil-to-lymphocyte ratio (NLR), clinical scoring, and treatment methods were collected. Interventional therapy included short-term nerve electrical stimulation (st-NES), pulsed radiofrequency (PRF) and radiofrequency thermocoagulation (RF-TC). Patients were categorized into poor prognosis and control groups based on outcomes 3 months post-discharge. Multivariate logistic regression was used to identify risk factors for poor prognosis.</p><p><strong>Results: </strong>The final analysis included 282 patients. The rate of poor prognosis was 32.6% (92/282). Multivariate logistic regression analysis revealed that age ≥ 65 years (odds ratio, 2.985; 95% confidence interval, 1.449-6.148; <i>p</i> = 0.003), disease duration >3 months (odds ratio, 3.135; 95% confidence interval, 1.685-5.832; <i>p</i> < 0.001), head and face pain (odds ratio, 3.140; 95% confidence interval, 1.557-6.330; <i>p</i> = 0.001), use of immunosuppressants (odds ratio, 2.737; 95% confidence interval, 1.168-6.416; <i>p</i> = 0.021), higher NLR (odds ratio, 1.454; 95% confidence interval, 1.233-1.715; <i>p</i> < 0.001), PRF (st-NES as reference) (odds ratio, 2.324; 95% confidence interval, 1.116-4.844; <i>p</i> = 0.024) and RF-TC (st-NES as reference) (odds ratio, 5.028; 95% confidence interval, 2.139-11.820; <i>p</i> < 0.001) were found to be independent risk factors for poor prognosis in patients with ZAN who underwent interventional pain management.</p><p><strong>Conclusion: </strong>Age ≥ 65 years (odds ratio, 2.985; 95% confidence interval, 1.449-6.148; <i>p</i> = 0.003), disease duration >3 months (odds ratio, 3.135; 95% confidence interval, 1.685-5.832; <i>p</i> < 0.001), head and face pain (odds ratio, 3.140; 95% confidence interval, 1.557-6.330; <i>p</i> = 0.001), immunosuppressants use (odds ratio, 2.737; 95% confidence interval, 1.168-6.416; <i>p</i> = 0.021), higher NLR (odds ratio, 1.454; 95% confidence interval, 1.233-1.715; <i>p</i> < 0.001), PRF (odds ratio, 2.324; 95% confidence interval, 1.116-4.844; <i>p</i> = 0.024) and RF-TC (odds ratio, 5.028; 95% confidence interval, 2.139-11.820; <i>p</i> < 0.001) were identified as independent risk factors for poor prognosis in patients with ZAN who underwent interventional pain management.</p>","PeriodicalId":12630,"journal":{"name":"Frontiers in Molecular Neuroscience","volume":"17 ","pages":"1393219"},"PeriodicalIF":3.5000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480953/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk factors for poor prognosis in patients with zoster-associated neuralgia who underwent interventional pain management.\",\"authors\":\"Junpeng Yuan, Youjia Yu, Hong Liu, Huichan Xu, Yan Li, Xiaohong Jin\",\"doi\":\"10.3389/fnmol.2024.1393219\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Zoster-associated neuralgia (ZAN) is recognized as a challenging neuralgia that often leads to poor prognosis in patients receiving interventional pain management. Identifying risk factors early can enable clinicians to develop personalized treatment plans; however, research in this area is limited.</p><p><strong>Methods: </strong>We retrospectively screened all patients with ZAN who received interventional therapy in the Pain Department of Soochow University First Affiliated Hospital from January 1, 2022 to August 31, 2023. Data on patient demographics, medical history, neutrophil-to-lymphocyte ratio (NLR), clinical scoring, and treatment methods were collected. Interventional therapy included short-term nerve electrical stimulation (st-NES), pulsed radiofrequency (PRF) and radiofrequency thermocoagulation (RF-TC). Patients were categorized into poor prognosis and control groups based on outcomes 3 months post-discharge. Multivariate logistic regression was used to identify risk factors for poor prognosis.</p><p><strong>Results: </strong>The final analysis included 282 patients. The rate of poor prognosis was 32.6% (92/282). Multivariate logistic regression analysis revealed that age ≥ 65 years (odds ratio, 2.985; 95% confidence interval, 1.449-6.148; <i>p</i> = 0.003), disease duration >3 months (odds ratio, 3.135; 95% confidence interval, 1.685-5.832; <i>p</i> < 0.001), head and face pain (odds ratio, 3.140; 95% confidence interval, 1.557-6.330; <i>p</i> = 0.001), use of immunosuppressants (odds ratio, 2.737; 95% confidence interval, 1.168-6.416; <i>p</i> = 0.021), higher NLR (odds ratio, 1.454; 95% confidence interval, 1.233-1.715; <i>p</i> < 0.001), PRF (st-NES as reference) (odds ratio, 2.324; 95% confidence interval, 1.116-4.844; <i>p</i> = 0.024) and RF-TC (st-NES as reference) (odds ratio, 5.028; 95% confidence interval, 2.139-11.820; <i>p</i> < 0.001) were found to be independent risk factors for poor prognosis in patients with ZAN who underwent interventional pain management.</p><p><strong>Conclusion: </strong>Age ≥ 65 years (odds ratio, 2.985; 95% confidence interval, 1.449-6.148; <i>p</i> = 0.003), disease duration >3 months (odds ratio, 3.135; 95% confidence interval, 1.685-5.832; <i>p</i> < 0.001), head and face pain (odds ratio, 3.140; 95% confidence interval, 1.557-6.330; <i>p</i> = 0.001), immunosuppressants use (odds ratio, 2.737; 95% confidence interval, 1.168-6.416; <i>p</i> = 0.021), higher NLR (odds ratio, 1.454; 95% confidence interval, 1.233-1.715; <i>p</i> < 0.001), PRF (odds ratio, 2.324; 95% confidence interval, 1.116-4.844; <i>p</i> = 0.024) and RF-TC (odds ratio, 5.028; 95% confidence interval, 2.139-11.820; <i>p</i> < 0.001) were identified as independent risk factors for poor prognosis in patients with ZAN who underwent interventional pain management.</p>\",\"PeriodicalId\":12630,\"journal\":{\"name\":\"Frontiers in Molecular Neuroscience\",\"volume\":\"17 \",\"pages\":\"1393219\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-10-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480953/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Molecular Neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fnmol.2024.1393219\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Molecular Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fnmol.2024.1393219","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Risk factors for poor prognosis in patients with zoster-associated neuralgia who underwent interventional pain management.
Background: Zoster-associated neuralgia (ZAN) is recognized as a challenging neuralgia that often leads to poor prognosis in patients receiving interventional pain management. Identifying risk factors early can enable clinicians to develop personalized treatment plans; however, research in this area is limited.
Methods: We retrospectively screened all patients with ZAN who received interventional therapy in the Pain Department of Soochow University First Affiliated Hospital from January 1, 2022 to August 31, 2023. Data on patient demographics, medical history, neutrophil-to-lymphocyte ratio (NLR), clinical scoring, and treatment methods were collected. Interventional therapy included short-term nerve electrical stimulation (st-NES), pulsed radiofrequency (PRF) and radiofrequency thermocoagulation (RF-TC). Patients were categorized into poor prognosis and control groups based on outcomes 3 months post-discharge. Multivariate logistic regression was used to identify risk factors for poor prognosis.
Results: The final analysis included 282 patients. The rate of poor prognosis was 32.6% (92/282). Multivariate logistic regression analysis revealed that age ≥ 65 years (odds ratio, 2.985; 95% confidence interval, 1.449-6.148; p = 0.003), disease duration >3 months (odds ratio, 3.135; 95% confidence interval, 1.685-5.832; p < 0.001), head and face pain (odds ratio, 3.140; 95% confidence interval, 1.557-6.330; p = 0.001), use of immunosuppressants (odds ratio, 2.737; 95% confidence interval, 1.168-6.416; p = 0.021), higher NLR (odds ratio, 1.454; 95% confidence interval, 1.233-1.715; p < 0.001), PRF (st-NES as reference) (odds ratio, 2.324; 95% confidence interval, 1.116-4.844; p = 0.024) and RF-TC (st-NES as reference) (odds ratio, 5.028; 95% confidence interval, 2.139-11.820; p < 0.001) were found to be independent risk factors for poor prognosis in patients with ZAN who underwent interventional pain management.
Conclusion: Age ≥ 65 years (odds ratio, 2.985; 95% confidence interval, 1.449-6.148; p = 0.003), disease duration >3 months (odds ratio, 3.135; 95% confidence interval, 1.685-5.832; p < 0.001), head and face pain (odds ratio, 3.140; 95% confidence interval, 1.557-6.330; p = 0.001), immunosuppressants use (odds ratio, 2.737; 95% confidence interval, 1.168-6.416; p = 0.021), higher NLR (odds ratio, 1.454; 95% confidence interval, 1.233-1.715; p < 0.001), PRF (odds ratio, 2.324; 95% confidence interval, 1.116-4.844; p = 0.024) and RF-TC (odds ratio, 5.028; 95% confidence interval, 2.139-11.820; p < 0.001) were identified as independent risk factors for poor prognosis in patients with ZAN who underwent interventional pain management.
期刊介绍：
Frontiers in Molecular Neuroscience is a first-tier electronic journal devoted to identifying key molecules, as well as their functions and interactions, that underlie the structure, design and function of the brain across all levels. The scope of our journal encompasses synaptic and cellular proteins, coding and non-coding RNA, and molecular mechanisms regulating cellular and dendritic RNA translation. In recent years, a plethora of new cellular and synaptic players have been identified from reduced systems, such as neuronal cultures, but the relevance of these molecules in terms of cellular and synaptic function and plasticity in the living brain and its circuits has not been validated. The effects of spine growth and density observed using gene products identified from in vitro work are frequently not reproduced in vivo. Our journal is particularly interested in studies on genetically engineered model organisms (C. elegans, Drosophila, mouse), in which alterations in key molecules underlying cellular and synaptic function and plasticity produce defined anatomical, physiological and behavioral changes. In the mouse, genetic alterations limited to particular neural circuits (olfactory bulb, motor cortex, cortical layers, hippocampal subfields, cerebellum), preferably regulated in time and on demand, are of special interest, as they sidestep potential compensatory developmental effects.
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