评估怀疑是早期髋关节骨关节炎(OA)的患者的临床相关疼痛波动和髋关节疼痛过程的10年随访期间的患病率。区分有疼痛相关波动的参与者和没有基于基线特征的参与者。
在基线和2、5、8和10年后,收集了495名来自队列髋部和队列膝关节研究(CHECK)的基线髋部疼痛参与者的数据。基线人口统计,记忆,和体格检查特征进行了评估。主要结果是随访评估中过去一周的疼痛水平(使用0-10数字评定量表评分)。相关波动定义为随着时间的推移将直线拟合到参与者的疼痛评分后,平均绝对残差大于1。
大多数参与者(76%)疼痛稳定或减轻。在37%的参与者中发现了相关的波动。以下基线变量与相关波动的存在正相关:过去一周疼痛水平较高,使用疼痛转化作为一种应对方式,更多的合并症,使用止痛药,和更高水平的高敏C反应蛋白。未发现基线影像学髋部OA或临床髋部OA的关联。
在为期10年的随访中,大多数参与者的疼痛水平稳定或降低.在有相关波动的参与者中(37%),有限数量的基线变量与疼痛发生相关波动的几率增加相关.
疼痛似乎是咨询全科医生(GP)髋关节骨关节炎(OA)投诉的重要原因。我们知道髋部疼痛在过去10年中保持相当稳定。还已知疼痛患者之间存在相当大的差异。在这项研究中,我们发现37%的初级保健患者在10年内出现了相关的疼痛波动.疼痛波动与骨关节炎无关,基线时既没有影像学上的髋部OA(根据X线诊断),也没有临床上的髋部OA(根据美国风湿病学会(ACR)标准确定).需要更多的研究来发现为什么有些人比其他人经历时间波动。
To evaluate the prevalence during a 10-year follow-up of clinically relevant
fluctuations in pain and the course of hip pain in participants with hip complaints suspected to be early stage hip osteoarthritis (OA). To distinguish between participants with relevant fluctuations in pain and those without based on baseline characteristics.
Data were collected at baseline and after 2, 5, 8, and 10 years on 495 participants from the Cohort Hip and Cohort Knee
Study (CHECK) with hip pain at baseline. Baseline demographic, anamnestic, and physical-examination characteristics were assessed. The primary outcome was levels of pain in the past week (scored using 0-10 Numeric Rating Scale) at follow-up assessments. Relevant fluctuation was defined as average absolute residuals greater than 1 after fitting a straight line to the participant\'s pain scores over time.
The majority of the participants (76%) had stable or decreasing pain. Relevant
fluctuations were found in 37% of the participants. The following baseline variables were positively associated with the presence of relevant fluctuations: higher levels of pain in the past week, use of pain transformation as a coping style, higher number of comorbidities, use of pain medication, and higher levels of high-sensitivity C-reactive protein. No associations were found for baseline radiographic hip OA or clinical hip OA.
During a 10-year follow-up, the majority of participants had stable or decreasing pain levels. In those participants with relevant fluctuation (37%), a limited number of baseline variables were associated with increased odds of having relevant fluctuations in pain.
Pain appears to be an important reason for consulting the general practitioner (GP) for hip osteoarthritis (OA) complaints. We know that hip pain remained quite stable over 10 years. Also is known that there is considerable variety between patients in pain. In this
study, we found relevant pain
fluctuations in 37% of primary care patients with hip complaints over a period of 10 years. The pain fluctuation was not associated with having osteoarthritis, neither radiographic hip OA (diagnosed based on a X-ray) or clinical hip OA (determined according to the American College of Rheumatology (ACR) criteria) at baseline. More research is needed to discover why some people experience
fluctuations in time than others.