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Tytuł:
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Chronic Pain Increases the Risk for Major Adverse Cardiac and Cerebrovascular Events: A Nationwide Population-Based Study in Asia.
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Autorzy:
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Chung, Kun-Ming
Ho, Chung-Han
Chen, Yi-Chen
Hsu, Chien-Chin
Chiu, Chong-Chi
Lin, Hung-Jung
Wang, Jhi-Joung
Huang, Chien-Cheng
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Temat:
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CEREBROVASCULAR disease risk factors
CARDIOVASCULAR diseases risk factors
CHRONIC pain
CONFIDENCE intervals
DEMENTIA
MENTAL depression
DIABETES
GOUT
HEADACHE
HYPERLIPIDEMIA
HYPERTENSION
KIDNEY diseases
LIVER diseases
LONGITUDINAL method
OBSTRUCTIVE lung diseases
SPINE diseases
MORTALITY
OSTEOARTHRITIS
OSTEOPOROSIS
HEALTH outcome assessment
PAIRED comparisons (Mathematics)
REGRESSION analysis
RISK assessment
PROPORTIONAL hazards models
DATA analysis software
DESCRIPTIVE statistics
ODDS ratio
DISEASE complications
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Źródło:
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Pain Medicine; Sep2020, Vol. 21 Issue 9, p1985-1990, 6p
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Objective Chronic pain (CP) may increase the risk for major adverse cardiac and cerebrovascular events (MACCEs); however, this issue is still unclear in the Asian population. We conducted this study to delineate it. Design From the Taiwan National Health Insurance Research Database, we identified 17,614 participants (<65 years) with CP and matched them by age and sex at a 1:2 ratio to participants without CP, who made up the comparison cohort. Several causes of CP and its underlying comorbidities were also analyzed. Outcome Measure A comparison of MACCE occurring in the two cohorts was performed via follow-up until 2015. Results The mean age (SD) was 50.2 (11.5) years and 50.4 (11.7) years in participants with and without CP, respectively. In both cohorts, the percentage of female participants was 55.5%. Common causes of CP were spinal disorders (23.9%), osteoarthritis (12.4%), headaches (11.0%), gout (10.2%), malignancy (6.2%), and osteoporosis (4.5%). After adjusting for hypertension, diabetes, chronic obstructive pulmonary disease, renal diseases, hyperlipidemia, liver diseases, dementia, and depression, participants with CP had a higher risk for MACCE than those without CP (adjusted hazard ratio [AHR] = 1.3, 95% confidence interval [CI] = 1.3 − 1.4). After conducting subgroup analyses, an increased risk was also found for all-cause mortality (AHR = 1.4, 95% CI = 1.1 − 1.8), acute myocardial infarction (AHR = 1.2, 95% CI = 1.0 − 1.4), and stroke (AHR = 1.3, 95% CI = 1.3 − 1.4). Conclusions CP is associated with increased occurrence of MACCE. Early detection and interventions for CP are suggested. [ABSTRACT FROM AUTHOR]
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