我国3省市门诊中老年慢性疼痛患者流行特征分析*

ANALYSIS OF THE EPIDEMIC CHARACTERISTICS OF OUTPATIENT MIDDLE-AGED AND ELDERLY CHRONIC PAIN PATIENTS IN 3 PROVINCES AND CITIES IN CHINA *

摘要:

目的:调查了解我国3省市门诊中老年慢性疼痛患者流行特征。方法:2023年4月至8月,采用多阶段分层抽样方法,在江西省、北京市、重庆市各抽取一家三级甲等综合医院和二级甲等综合医院,纳入年龄≥45岁、主诉疼痛时间持续超过3个月的门诊慢性疼痛患者。通过问卷调查了解调查对象的一般情况和慢性疼痛流行特征。计数资料用率表示,组间比较采用χ2检验,采用多元logistic回归分析患者疼痛程度的影响因素。结果:纳入分析的有效样本为4151例门诊慢性疼痛患者,其中男性1803例(43.4%)、女性2348例(56.6%)；45~64岁2193例(52.8%)、≥65岁1958例(47.2%)。调查对象疼痛轻、中、重度分别为1079例(26.0%)、2535例(61.1%)、537例(12.9%)。不同年龄(χ2=43.847,P<0.001)、地区(χ2=945.384,P<0.001)、城乡(χ2=135.31,P<0.001)、文化程度(χ2=39.465,P<0.001)、工作状况(χ2=34.433,P<0.001)、家庭年收入(χ2=166.948,P<0.001)、既往病史(χ2=15.467,P<0.001)、饮酒状况(χ2=13.482,P<0.01)、疼痛年限(χ2=24.901,P<0.001)、疼痛部位(χ2=108.191,P<0.001)与患者疼痛程度分布差异有统计学意义(P<0.05)。多元logistic回归分析结果显示,年龄≥65岁(OR=1.89,95%CI:1.41～2.54)、居住在农村(OR=2.44,95%CI:1.70～3.51)、疼痛部位≥2处(OR=2.66,95%CI:2.05～3.46)、从不饮酒(OR=1.48,95%CI:1.01～2.12)是重度疼痛的危险因素；居住地为中部地区(OR=1.36,95%CI:1.01～1.83)、在业人员(OR=1.24,95%CI:1.03～1.50)、疼痛部位≥2处(OR=1.76,95%CI:1.49～2.08)是中度疼痛的危险因素,均有统计学意义(P<0.05)。结论:我国3省市门诊中老年慢性疼痛患者以中度疼痛为主。年龄、城乡、疼痛部位是疼痛程度的重要影响因素。应尽早识别和干预相关影响因素,以便更全面地评估疼痛程度和制定个性化的治疗方案,从而改善患者疼痛治疗和管理效果。

Abstract:

Objective: To investigate the epidemic characteristics of elderly chronic pain patients in outpatient department in 3 provinces and cities in China. Methods: From April to August 2023, a multi-stage stratified sampling method was used to select a tertiary class A general hospital and a secondary class A general hospital in each of Beijing, Chongqing, Jiangxi Province, and included chronic pain patients aged 45 years and older who had been experiencing pain for over 3 months. Questionnaire was used to collect information about the patients" general characteristics and the epidemiological features of chronic pain. The χ2 test was performed for inter-group comparisons and multiple logistic regression analysis was used to identify factors influencing the severity of pain in patients. Results: The effective sample size for analysis included 4,151 outpatient chronic pain patients, comprising 1,803 males (43.4%) and 2,348 females (56.6%). Pain severity was categorized as mild in 1,079 cases (26.0%), moderate in 2,535 cases (61.1%), and severe in 537 cases (12.9%). Significant differences in pain severity distribution were observed based on age (χ2=43.847, P<0.001), region (χ2=945.384, P<0.001), urban and rural (χ2=135.31, P<0.001), education level (χ2=39.465, P<0.001), employment status (χ2=34.433, P<0.001), family annual income (χ2=166.948, P<0.001), previous history (χ2=15.467, P<0.001), drinking (χ2=13.482, P<0.01), pain duration (χ2=24.901, P<0.001), pain site(χ2=108.191, P<0.001) and pain intensity distribution were statistically significant (P<0.05). Multiple logistic regression analysis showed that age ≥65 years old (OR=1.89,95%CI: 1.41～2.54), living in rural areas (OR=2.44,95%CI: 1.70～3.51), ≥2 pain sites (OR=2.66,95%CI: 2.05～3.46), no-drinking (OR=1.48,95%CI:1.01～2.12) is a risk factor for severe pain; The central region (OR=1.36,95%CI:1.01～1.83), the employed person (OR=1.24,95%CI:1.03～1.50) and pain sites≥2 (OR=1.76,95%CI:1.49～2.08) were the risk factors for moderate pain, with statistical significance (P<0.05). Conclusion: In outpatient department across three provinces and cities in China, middle-aged and elderly patients predominantly experience moderate chronic pain. Age, urban or rural residence, and the location of pain are significant influencing factors for pain severity. Early identification and intervention of these relevant factors are essential to comprehensively assess pain levels and develop personalized treatment plans, ultimately enhancing the effectiveness of pain management and treatment for patients.