PDF(Pubmed)
Abstract：
OBJECTIVE: Postdural puncture headache (PDPH) is an acknowledged consequence of procedures like lumbar punctures, epidural analgesia, and neurosurgical interventions. Persistence over more than three months, however has been poorly studied. In particular, little is known about the impact of persistent PDPH (pPDPH) on health related quality of life (HRQoL), disability and ability to work. The study aimed to provide a holistic understanding of pPDPH, encompassing medical, physical and psychological aspects.
METHODS: We conducted a cross-sectional anonymous online survey in individuals aged 18 or older, diagnosed with, or suspected to have pPDPH via self-help groups on Facebook. Participants completed a structured questionnaire covering diagnosis, symptoms, and the ability to work. For assessing headache related disability, and mental health, they filled in the Henry Ford Hospital Headache Disability Inventory (HDI) and the Depression Anxiety Stress Scale-21 (DASS-21).
RESULTS: A total of 179 participants (83.2% female, mean age 39.7 years) completed the survey. PPDPH had been present for one year or more in 74.3%, and 44.1% were unable to be in an upright position for more than one hour per day without having to lie down or sit down. Headaches were extremely severe or severe in 18% and 34%, respectively. According to the HDI, 31.8% of participants had mild, 25.7% moderate, and 42.5% severe disability. DASS-21 revealed substantial mental health challenges with depression, anxiety and stress experienced by 83%, 98%, and 88% of the respondents. The ability to work was limited considerably: 27.9% were unable to work, 59.8% worked part-time, 1.1% changed their job because of pPDPH, and only 11.2% were able to work full-time in their previous job. Despite treatment, the patients\' condition had deteriorated in 32.4% and remained unchanged in 27.9%.
CONCLUSIONS: This study stresses the burden of pPDPH in terms of substantial disability, limited quality of life, mental health concerns, and significant impact on the ability to work. The study highlights the long-term impact of pPDPH on individuals, emphasizing the need for timely diagnosis and effective treatment. It underscores the complexity of managing pPDPH and calls for further research into its long-term effects on patient health and HRQoL.
METHODS: We conducted a cross-sectional anonymous online survey in individuals aged 18 or older, diagnosed with, or suspected to have pPDPH via self-help groups on Facebook. Participants completed a structured questionnaire covering diagnosis, symptoms, and the ability to work. For assessing headache related disability, and mental health, they filled in the Henry Ford Hospital Headache Disability Inventory (HDI) and the Depression Anxiety Stress Scale-21 (DASS-21).
RESULTS: A total of 179 participants (83.2% female, mean age 39.7 years) completed the survey. PPDPH had been present for one year or more in 74.3%, and 44.1% were unable to be in an upright position for more than one hour per day without having to lie down or sit down. Headaches were extremely severe or severe in 18% and 34%, respectively. According to the HDI, 31.8% of participants had mild, 25.7% moderate, and 42.5% severe disability. DASS-21 revealed substantial mental health challenges with depression, anxiety and stress experienced by 83%, 98%, and 88% of the respondents. The ability to work was limited considerably: 27.9% were unable to work, 59.8% worked part-time, 1.1% changed their job because of pPDPH, and only 11.2% were able to work full-time in their previous job. Despite treatment, the patients\' condition had deteriorated in 32.4% and remained unchanged in 27.9%.
CONCLUSIONS: This study stresses the burden of pPDPH in terms of substantial disability, limited quality of life, mental health concerns, and significant impact on the ability to work. The study highlights the long-term impact of pPDPH on individuals, emphasizing the need for timely diagnosis and effective treatment. It underscores the complexity of managing pPDPH and calls for further research into its long-term effects on patient health and HRQoL.
摘要：
目的：硬膜穿刺后头痛（PDPH）是腰椎穿刺等手术的公认后果，硬膜外镇痛，和神经外科干预。坚持三个多月，然而，研究很少。特别是,关于持续性PDPH（pPDPH）对健康相关生活质量（HRQoL）的影响知之甚少，残疾和工作能力。该研究旨在提供对pPDPH的全面理解，包括医疗，生理和心理方面。
方法：我们对18岁或以上的个人进行了横断面匿名在线调查，诊断为，或怀疑通过Facebook上的自助小组有pPDPH。参与者完成了一份涵盖诊断的结构化问卷，症状,和工作能力。为了评估头痛相关的残疾，和心理健康，他们填写了亨利·福特医院头痛障碍量表（HDI）和抑郁焦虑压力量表-21（DASS-21）。
结果：共有179名参与者（83.2%为女性，平均年龄39.7岁)完成调查。74.3%的人出现在PPDPH一年或一年以上，44.1%的人每天不能直立超过一小时而不必躺下或坐下。18％和34％的头痛非常严重或严重，分别。根据HDI,31.8%的参与者有轻度，25.7%中等,42.5%的严重残疾。DASS-21揭示了抑郁症带来的重大心理健康挑战，83%的人经历了焦虑和压力，98%,88%的受访者。工作能力受到很大限制：27.9%的人无法工作，59.8%兼职,1.1%的人因为pPDPH改变了工作，只有11.2%的人能够在以前的工作中全职工作。尽管治疗,32.4%的患者病情恶化，27.9%的患者保持不变。
结论：这项研究强调了pPDPH在实质性残疾方面的负担，生活质量有限，心理健康问题，并对工作能力产生重大影响。该研究强调了pPDPH对个体的长期影响，强调需要及时诊断和有效治疗。它强调了管理pPDPH的复杂性，并呼吁进一步研究其对患者健康和HRQoL的长期影响。
方法：我们对18岁或以上的个人进行了横断面匿名在线调查，诊断为，或怀疑通过Facebook上的自助小组有pPDPH。参与者完成了一份涵盖诊断的结构化问卷，症状,和工作能力。为了评估头痛相关的残疾，和心理健康，他们填写了亨利·福特医院头痛障碍量表（HDI）和抑郁焦虑压力量表-21（DASS-21）。
结果：共有179名参与者（83.2%为女性，平均年龄39.7岁)完成调查。74.3%的人出现在PPDPH一年或一年以上，44.1%的人每天不能直立超过一小时而不必躺下或坐下。18％和34％的头痛非常严重或严重，分别。根据HDI,31.8%的参与者有轻度，25.7%中等,42.5%的严重残疾。DASS-21揭示了抑郁症带来的重大心理健康挑战，83%的人经历了焦虑和压力，98%,88%的受访者。工作能力受到很大限制：27.9%的人无法工作，59.8%兼职,1.1%的人因为pPDPH改变了工作，只有11.2%的人能够在以前的工作中全职工作。尽管治疗,32.4%的患者病情恶化，27.9%的患者保持不变。
结论：这项研究强调了pPDPH在实质性残疾方面的负担，生活质量有限，心理健康问题，并对工作能力产生重大影响。该研究强调了pPDPH对个体的长期影响，强调需要及时诊断和有效治疗。它强调了管理pPDPH的复杂性，并呼吁进一步研究其对患者健康和HRQoL的长期影响。
