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Pain phenotypes among adults living with cerebral palsy and spina bifida.
Pain ( IF 7.4 ) Pub Date : 2021-9-18 , DOI: 10.1097/j.pain.0000000000002240
Mark D Peterson 1, 2 , Heidi Haapala 1 , Neil Kamdar 2, 3, 4, 5 , Paul Lin 2 , Edward A Hurvitz 1
Affiliation  

Chronic pain is the most commonly reported physical symptomology of cerebral palsy (CP) and spina bifida (SB) throughout the lifespan, and yet, pain is perhaps the least understood comorbidity in these populations. The objective of this study was to compare the prevalence and types of pain diagnosed among adults living with and without CP or SB. In this retrospective cohort study, we analyzed data from a nationwide commercial insurance claims database. Beneficiaries were included if they had an International Classification of Diseases, Ninth revision, Clinical Modification diagnosis code for CP or SB (n = 22,648). Adults without CP or SB were also included as controls (n = 931,623). Pain phenotypes (nociceptive, nociplastic, and neuropathic pain) and pain multimorbidity (≥2 conditions) were compared. We found that adults living with CP or SB had a higher prevalence of any pain disorders (55.9% vs 35.2%), nociceptive pain (44.0% vs 26.7%), nociplastic pain (26.1% vs 11.9%), neuropathic pain (9.6% vs 5.6%), and pain multimorbidity (21.1% vs 8.4%), as compared to adults without CP or SB, and differences were to a clinically meaningful extent. Adjusted odds ratios of nociceptive pain (odds ratio [OR]: 2.20; 95% confidence interval [CI]: 2.15-2.24), nociplastic pain (OR: 2.47; 95% CI: 2.41-2.53), neuropathic pain (OR: 2.71; 95% CI: 2.54-2.89), and other pain (OR: 3.92; 95% CI: 3.67-4.19) were significantly higher for adults living with CP or SB. In conclusion, adults with CP or SB have a significantly higher prevalence and odds of common peripheral, central, and neuropathic pain disorders and pain multimorbidity, as compared to adults without CP or SB.

中文翻译:

患有脑瘫和脊柱裂的成年人的疼痛表型。

慢性疼痛是脑瘫 (CP) 和脊柱裂 (SB) 一生中最常见的身体症状,然而,疼痛可能是这些人群中最不为人所知的合并症。本研究的目的是比较患有和不患有 CP 或 SB 的成年人中诊断出的疼痛的患病率和类型。在这项回顾性队列研究中,我们分析了全国商业保险理赔数据库的数据。如果受益人拥有国际疾病分类第九次修订版、临床修改 CP 或 SB 诊断代码 (n = 22,648),则受益人将被纳入其中。没有 CP 或 SB 的成年人也作为对照 (n = 931,623)。比较疼痛表型(伤害性疼痛、伤害性疼痛和神经性疼痛)和疼痛多发病(≥2种情况)。我们发现,患有 CP 或 SB 的成年人患有任何疼痛疾病(55.9% vs 35.2%)、伤害性疼痛(44.0% vs 26.7%)、伤害性疼痛(26.1% vs 11.9%)、神经性疼痛(9.6%)的患病率较高。与没有 CP 或 SB 的成人相比,差异性达到了具有临床意义的程度。伤害性疼痛的调整比值比(比值比 [OR]:2.20;95% 置信区间 [CI]:2.15-2.24)、伤害性疼痛(OR:2.47;95% CI:2.41-2.53)、神经性疼痛(OR:2.71)患有 CP 或 SB 的成人的 CP 或 SB 患者的疼痛(OR:3.92;95% CI:3.67-4.19)和其他疼痛显着更高。总之,与没有 CP 或 SB 的成年人相比,患有 CP 或 SB 的成年人常见外周、中枢和神经性疼痛疾病以及疼痛多发病的患病率和几率明显更高。
更新日期:2021-09-18
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