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5.
BMC Public Health ; 20(1): 1462, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993730

RESUMO

BACKGROUND: Previous studies suggest that immigration may influence the experience of pain. OBJECTIVE: This population-based study examines whether immigration status is associated with chronic pain (CP), chronic widespread pain (CWSP), and severe CP at a two-year follow-up. We also tested mediation by mood status (i.e., anxiety and depression). METHODS: 15, 563 participants from a representative stratified random sample of 34,000 individuals living in south-eastern Sweden completed a postal survey, during 2013-2015, that included the following data: immigration status; presence of CP (pain lasting at least 3 months) and CWSP (a modified classification of widespread pain for use in epidemiological studies); severity of CP based on a numeric rating scale; and depression, anxiety, economic situation, and sociodemographic information. We applied logistic regressions using the generalized estimating equations (GEE), with Swedish-born as the reference group and path analyses models. RESULTS: Compared to the Swedish-born participants (n = 14,093;90%), the immigrants (n = 1470;10%) had an elevated risk of all pain outcomes (CP: odds ratio [OR] = 1.18; 95% confidence interval [CI = 1.04-1.33, CWSP: OR = 1.39; 95% CI: 1.15-1.69 and severe CP: 1.51; 95% CI: 1.23-1.87) after adjustments. Path analyses showed that baseline age, immigrant status, and financial hardship had a significant influence on chronic pain outcomes at follow-up with baseline mood status as the mediator. Immigration status was also associated with age and financial hardship. CONCLUSION: Immigrants may have increased risk of chronic pain, widespread pain, and severe pain and this risk is mediated by mood status. Targeted interventions better tailored to the socio-economic and psychological status of immigrants with chronic pain are warranted.


Assuntos
Dor Crônica/epidemiologia , Emigração e Imigração/estatística & dados numéricos , Adulto , Ansiedade/epidemiologia , Estudos de Coortes , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Grupos Populacionais , Inquéritos e Questionários , Suécia
6.
Transl Behav Med ; 10(4): 827-834, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-32885815

RESUMO

The COVID-19 pandemic has slowed research progress, with particularly disruptive effects on investigations of addressing urgent public health challenges, such as chronic pain. The National Institutes of Health (NIH) Department of Defense (DoD) Department of Veterans Affairs (VA) Pain Management Collaboratory (PMC) supports 11 large-scale, multisite, embedded pragmatic clinical trials (PCTs) in military and veteran health systems. The PMC rapidly developed and enacted a plan to address key issues in response to the COVID-19 pandemic. The PMC tracked and collaborated in developing plans for addressing COVID-19 impacts across multiple domains and characterized the impact of COVID-19 on PCT operations, including delays in recruitment and revisions of study protocols. A harmonized participant questionnaire will facilitate later meta-analyses and cross-study comparisons of the impact of COVID-19 across all 11 PCTs. The pandemic has affected intervention delivery, outcomes, regulatory and ethics issues, participant recruitment, and study design. The PMC took concrete steps to ensure scientific rigor while encouraging flexibility in the PCTs, while paying close attention to minimizing the burden on research participants, investigators, and clinical care teams. Sudden changes in the delivery of pain management interventions will probably alter treatment effects measured via PMC PCTs. Through the use of harmonized instruments and surveys, we are capturing these changes and plan to monitor the impact on research practices, as well as on health outcomes. Analyses of patient-reported measures over time will inform potential relationships between chronic pain, mental health, and various socioeconomic stressors common among Americans during the COVID-19 pandemic.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus , Saúde Mental/tendências , Manejo da Dor , Pandemias , Pneumonia Viral , Pesquisa , Betacoronavirus , Dor Crônica/epidemiologia , Dor Crônica/psicologia , Dor Crônica/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , National Institutes of Health (U.S.) , Manejo da Dor/ética , Manejo da Dor/métodos , Manejo da Dor/tendências , Pandemias/prevenção & controle , Seleção de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pesquisa/organização & administração , Pesquisa/tendências , Fatores Socioeconômicos , Estados Unidos/epidemiologia , United States Department of Veterans Affairs
7.
PLoS One ; 15(9): e0238634, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886704

RESUMO

BACKGROUND: Chronic post-surgical pain (CPSP) is one of the post-surgical complications of a Cesarean section. Despite the high rates of Cesarean section worldwide, the incidence of CPSP and the risk factors for this condition remain relatively unknown. The objective of this study was to calculate the incidence of CPSP in women submitted to Cesarean section and to analyze the associated risk factors. MATERIALS AND METHODS: A prospective cohort of 621 women undergoing Cesarean section was recruited preoperatively. Potential presurgical (sociodemographic, clinical and lifestyle-related characteristics) and post-surgical risk factors (the presence and intensity of pain) risk factors were analyzed. Pain was measured at 24 hours and 7, 30, 60 and 90 days after surgery. Following discharge from hospital, data were collected by telephone. The outcome measure was self-reported pain three months after a Cesarean section. The risk factors for chronic pain were analyzed using the log-binomial regression model (a generalized linear model). RESULTS: A total of 462 women were successfully contacted 90 days following surgery. The incidence of CPSP was 25.5% (95%CI: 21.8-29.7). Risk factors included presurgical anxiety (adjusted relative risk [RR] 1.03; 95%CI: 1.01-1.05), smoking (adjusted RR 2.22; 95%CI: 1.27-3.88) and severe pain in the early postoperative period (adjusted RR 2.79; 95%CI: 1.29-6.00). CONCLUSION: One in four women submitted to Cesarean section may develop CPSP; however, the risk factors identified here are modifiable and preventable. Preventive strategies directed towards controlling anxiety, reducing smoking during pregnancy and managing pain soon after hospital discharge are recommended.


Assuntos
Cesárea/efeitos adversos , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Estilo de Vida , Análise Multivariada , Gravidez , Fatores de Risco
8.
Sr Care Pharm ; 35(10): 406-407, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32972489

RESUMO

Over the past twenty five years, significant changes to the assessment and treatment of pain have occurred. In the 1990s, the identification of "pain as the fifth vital sign" impacted how providers assessed and treated pain. Now, with the opioid epidemic and recommendations from multiple organizations to remove pain as the fifth vital sign, the practice of pain management is changing again. Despite these changes, pain is still a common condition many patients experience. It is estimated about 50% of older adults in the community report daily pain, and there is an increased prevalence of pain in the facility setting, with 45-80% of residents reporting chronic pain impacting their quality of life. With the growing number of older adults in the United States, pharmacists working with geriatric patients need to be familiar with the treatment of pain and new approaches that are being utilized.


Assuntos
Manejo da Dor , Analgésicos Opioides/efeitos adversos , Dor Crônica/tratamento farmacológico , Dor Crônica/epidemiologia , Humanos , Farmacêuticos , Qualidade de Vida , Estados Unidos/epidemiologia
9.
PLoS One ; 15(9): e0239818, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32986777

RESUMO

BACKGROUND: The obesity epidemic has influenced pain rehabilitation clinics. To date, little is known about baseline level of physical activity (PA) in patients referred to pain rehabilitation clinics. We aimed to investigate the PA levels of patients referred to pain rehabilitation clinics and to evaluate the effect of excess weight on PA level. METHODS AND FINDINGS: Data were obtained from the Swedish Quality Registry for Pain Rehabilitation between 2016 and 2017. These data included PA time (everyday PA and physical exercise per week), Body Mass Index (BMI), sociodemographic factors, chronic pain and psychological aspects (e.g., pain intensity, depressive and anxiety symptoms and insomnia problems). Insufficient PA was defined as less than 150 minutes per week. We performed logistic regressions as well as orthogonal partial least square regression to estimate the effects of excess weight on PA. Over one-fourth of the patients were classified as obese (BMI ≥30 kg/m2, 871/3110, 25.3%) and nearly one-third of these patients were classified as severely obese (BMI ≥35 kg/m2, 242/871, 27.8%). Time estimations for physical exercise varied among the BMI groups, but patients in the higher BMI category were more likely to spend less time on everyday PA. Compared to normal weight, mild obesity [odds ratio (OR) 0.65, 95% confidence interval (CI) 0.53-0.81] and severe obesity (OR 0.56, 95% CI 0.42-0.74) were associated with less PA. Mild obese patients had an elevated risk of 65% and severe obese patients had an elevated risk of 96% for insufficient PA. Increased pain intensity was positively related to insufficient PA (OR 1.17, 95% CI 1.06-1.29) among the obese patients. CONCLUSION: Having low PA is very common for patients referred to pain rehabilitation clinics, especially for those with comorbid obesity. As a first step to increase PA, obese patients need to be encouraged to increase the intensity and amount of less painful daily PA.


Assuntos
Dor Crônica/epidemiologia , Dor Crônica/reabilitação , Exercício Físico , Obesidade/epidemiologia , Clínicas de Dor , Sistema de Registros , Adulto , Índice de Massa Corporal , Estudos de Coortes , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Risco , Autorrelato , Suécia/epidemiologia , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-32752085

RESUMO

Longitudinal research is needed to determine predictive factors of healthcare utilization and medication intake in people with non-specific spinal pain. This study aims to prospectively examine the predictive value of sex, age, work status, pain intensity, pain acceptance, disability, depression, pain anxiety, and catastrophizing in relation to healthcare utilization and medication intake in people with non-specific spinal pain. Participants were 79 patients with non-specific spinal pain of 6 to 9 months' duration. They were followed-up at 6 months and 12 months. At enrolment they were administered a battery of questionnaires assessing the predictive variables. Healthcare utilization and medication intake were assessed at follow-ups 1 and 2. At follow-up 1, higher pain acceptance was associated with less healthcare utilization and less medication intake, while male sex was associated with less medication intake. At follow-up 2, higher pain-related disability was associated with higher healthcare use, and pain intensity was associated with higher medication intake. These results suggest that during the early stages of non-specific spinal pain chronification, pain acceptance and the avoidance of pain-related disability-understood as giving up normal activities-can lead to reductions in healthcare utilization and medication intake.


Assuntos
Catastrofização , Dor Crônica , Pessoas com Deficiência , Dor , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Idoso , Ansiedade , Dor Crônica/tratamento farmacológico , Dor Crônica/epidemiologia , Depressão , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/psicologia , Inquéritos e Questionários
11.
PLoS One ; 15(8): e0236111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790685

RESUMO

A relationship between chronic pain and frailty has been reported. The early detection and prevention of frailty are recommended, in part because community-dwelling older adults in a pre-frailty state may return to a healthy state. The relationship between chronic pain and pre-frailty is not known. Toward the goal of promoting a reversible return to health from pre-frailty, we investigated the relationship between chronic pain and pre-frailty among community-dwelling older adults. We assessed the frailty and chronic pain of 107 older adults who were participating in community health checks. The status of physical frailty was based on the five components described by Fried (2001): muscle weakness shown by handgrip strength, slowness of gait speed, weight loss, low physical activity, and exhaustion. Chronic pain was assessed based on pain intensity, the Pain Catastrophizing Scale (PCS), the Japanese version of the Geriatric Depression Scale-15 (GDS-15), and the Central Sensitization Inventory (CSI). The prevalence of chronic pain with pre-frailty was 40.2%. A hierarchical analysis revealed that PCS-measured helplessness (odds ratio [OR]: 0.88) and the CSI (OR: 0.87) were significant factors associated with the presence of chronic pain with pre-frailty. The prevalence of chronic pain with pre-frailty was high, and chronic pain and pre-frailty were strongly related. New intervention or prevention programs that take into account both chronic pain and pre-frailty must be created as soon as possible.


Assuntos
Catastrofização/epidemiologia , Dor Crônica/epidemiologia , Fragilidade/prevenção & controle , Vida Independente , Debilidade Muscular/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Catastrofização/psicologia , Dor Crônica/complicações , Dor Crônica/diagnóstico , Dor Crônica/psicologia , Estudos Transversais , Feminino , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/diagnóstico , Fragilidade/etiologia , Avaliação Geriátrica , Força da Mão , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/diagnóstico , Debilidade Muscular/etiologia , Medição da Dor , Prevalência
12.
Br J Anaesth ; 125(3): 346-357, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32611524

RESUMO

BACKGROUND: The prevalence and intensity of persistent post-surgical pain (PPSP) after breast cancer surgery are uncertain. We conducted a systematic review and meta-analysis to further elucidate this issue. METHODS: We searched MEDLINE, Embase, CINAHL, and PsycINFO, from inception to November 2018, for observational studies reporting persistent pain (≥3 months) after breast cancer surgery. We used random-effects meta-analysis and the Grading of Recommendations, Assessment, Development and Evaluations approach to rate quality of evidence. RESULTS: We included 187 observational studies with 297 612 breast cancer patients. The prevalence of PPSP ranged from 2% to 78%, median 37% (inter-quartile range: 22-48%); the pooled prevalence was 35% (95% confidence interval [CI]: 32-39%). The pooled pain intensity was 3.9 cm on a 10 cm visual analogue scale (95% CI: 3.6-4.2 cm). Moderate-quality evidence supported the subgroup effects of PPSP prevalence for localized pain vs any pain (29% vs 44%), moderate or greater vs any pain (26% vs 44%), clinician-assessed vs patient-reported pain (23% vs 36%), and whether patients underwent sentinel lymph node biopsy vs axillary lymph node dissection (26% vs 43%). The adjusted analysis found that the prevalence of patient-reported PPSP (any severity/location) was 46% (95% CI: 36-56%), and the prevalence of patient-reported moderate-to-severe PPSP at any location was 27% (95% CI: 10-43%). CONCLUSIONS: Moderate-quality evidence suggests that almost half of all women undergoing breast cancer surgery develop persistent post-surgical pain, and about one in four develop moderate-to-severe persistent post-surgical pain; the higher prevalence was associated with axillary lymph node dissection. Future studies should explore whether nerve sparing for axillary procedures reduces persistent post-surgical pain after breast cancer surgery.


Assuntos
Neoplasias da Mama/cirurgia , Dor Crônica/epidemiologia , Estudos Observacionais como Assunto , Dor Pós-Operatória/epidemiologia , Neoplasias da Mama/epidemiologia , Feminino , Humanos , Prevalência , Índice de Gravidade de Doença
15.
Br J Anaesth ; 125(2): 149-158, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32564888

RESUMO

BACKGROUND: According to earlier studies where the main aim has been quality of life, there is growing evidence of increased levels of persistent pain in survivors of critical illness. The cause of admission and several factors during intensive care may have associated risk factors for pain persistence. This systematic review aims to determine the incidence or prevalence of persistent pain after critical illness and to identify risk factors for it. METHODS: Six databases were searched, and eventually nine studies were included in the final systematic process. The validity of observational and cross-sectional studies was analysed using the National Institute of Health 'Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies'. RESULTS: The incidence of persistent pain after intensive care varied from 28% to 77%. Risk factors for persistent pain were acute pain at discharge from ICU, higher thoracic trauma score, surgery, pre-existing pain, organ failure, longer length of ventilator or hospital stay, and sepsis. No difference in incidence between medical and surgical patients was found. CONCLUSIONS: New systematic, observational studies are warranted to identify persistent pain-related factors in intensive care to improve pain management protocols and thereby diminish the risk of persistent pain after ICU stay.


Assuntos
Dor Crônica/epidemiologia , Cuidados Críticos , Sobreviventes/estatística & dados numéricos , Estudos de Coortes , Estado Terminal , Estudos Transversais , Humanos , Incidência , Tempo de Internação , Prevalência , Fatores de Risco
16.
J Headache Pain ; 21(1): 78, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32560622

RESUMO

Chronic pain surrounding the temporomandibular joints and masticatory muscles is often the primary chief complaint of patients with temporomandibular disorders (TMD) seeking treatment. Yet, the neuro-pathophysiological basis underlying it remains to be clarified. Neuroimaging techniques have provided a deeper understanding of what happens to brain structure and function in TMD patients with chronic pain. Therefore, we performed a systematic review of magnetic resonance imaging (MRI) studies investigating structural and functional brain alterations in TMD patients to further unravel the neurobiological underpinnings of TMD-related pain. Online databases (PubMed, EMBASE, and Web of Science) were searched up to August 3, 2019, as complemented by a hand search in reference lists. A total of 622 papers were initially identified after duplicates removed and 25 studies met inclusion criteria for this review. Notably, the variations of MRI techniques used and study design among included studies preclude a meta-analysis and we discussed the findings qualitatively according to the specific neural system or network the brain regions were involved in. Brain changes were found in pathways responsible for abnormal pain perception, including the classic trigemino-thalamo-cortical system and the lateral and medial pain systems. Dysfunction and maladaptive changes were also identified in the default mode network, the top-down antinociceptive periaqueductal gray-raphe magnus pathway, as well as the motor system. TMD patients displayed altered brain activations in response to both innocuous and painful stimuli compared with healthy controls. Additionally, evidence indicates that splint therapy can alleviate TMD-related symptoms by inducing functional brain changes. In summary, MRI research provides important novel insights into the altered neural manifestations underlying chronic pain in TMD.


Assuntos
Encéfalo/diagnóstico por imagem , Dor Crônica/diagnóstico por imagem , Dor Facial/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Encéfalo/fisiopatologia , Dor Crônica/epidemiologia , Dor Crônica/fisiopatologia , Dor Facial/epidemiologia , Dor Facial/fisiopatologia , Feminino , Humanos , Masculino , Neuroimagem/métodos , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/fisiopatologia
17.
PLoS One ; 15(6): e0235419, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32589694

RESUMO

BACKGROUND: Physical inactivity and chronic pain are both major public health concerns worldwide. Although the health benefits of regular physical exercise are well-documented, few large epidemiological studies have investigated the association between specific domains of physical exercise and chronic pain in young adults. We sought to investigate the association between frequency, intensity and duration of physical exercise, and chronic pain. METHODS: Data stem from the SHoT2018-study, a national health survey for higher education in Norway, in which 36,625 fulltime students aged 18-35 years completed all relevant questionnaires. Chronic pain, defined according to the International Classification of Diseases 11th Revision (ICD-11), was assessed with a newly developed hierarchical digital instrument for reporting both distribution and characteristics of pain in predefined body regions. Physical exercise was assessed using three sets of questions, measuring the number of times exercising each week, and the average intensity and the number of hours each time. RESULTS: The majority (54%) of the students reported chronic pain in at least one location, and the prevalence was especially high among women. The overall pattern was an inverse dose-response association between exercise and chronic pain: the more frequent, harder or longer the physical exercise, the lower the risk of chronic pain. Similar findings were generally also observed for the number of pain locations: frequent exercise was associated with fewer pain locations. Adjusting for demographical, lifestyle factors and depression had little effect on the magnitude of the associations. CONCLUSION: Given the many health benefits of regular exercise, there is much to be gained in facilitating college and university students to be more physically active, ideally, thru a joint responsibility between political and educational institutions. Due to the cross-sectional nature of the study, one should be careful to draw a firm conclusion about the direction of causality.


Assuntos
Dor Crônica/fisiopatologia , Exercício Físico , Estudantes/estatística & dados numéricos , Universidades/estatística & dados numéricos , Adulto , Dor Crônica/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
18.
Rev Med Suisse ; 16(692): 885-889, 2020 May 06.
Artigo em Francês | MEDLINE | ID: mdl-32374530

RESUMO

The International Association for the Study of Pain (IASP) proposed the current diagnostic description of complex regional pain syndrome (CRPS) for the distinct and complex chronic pain condition in 1994. Since this classification, studies on the syndrome have led to a better understanding of the underlying pathophysiological mechanisms, epidemiology and therapeutic approaches. F. Luthi of SUVA Care reviewed CRPS in detail in 2014 and 2019 issues of the Revue médicale suisse. The purpose of this article is to provide an update of results on the neural mechanisms involved in this syndrome and how this helps management of CRPS, in particular bringing awareness to physicians of all specialties of the first symptoms with practical advice for investigations and treatment.


Assuntos
Encéfalo/fisiopatologia , Síndromes da Dor Regional Complexa/fisiopatologia , Síndromes da Dor Regional Complexa/terapia , Manejo da Dor , Dor Crônica/epidemiologia , Dor Crônica/fisiopatologia , Dor Crônica/terapia , Síndromes da Dor Regional Complexa/epidemiologia , Humanos
19.
Anesth Analg ; 131(2): 387-394, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32452905

RESUMO

BACKGROUND: The current coronavirus disease 2019 (COVID-19) pandemic led to a significant disruption in the care of pain from chronic and subacute conditions. The impact of this cessation of pain treatment may have unintended consequences of increased pain, reduced function, increased reliance on opioid medications, and potential increased morbidity, due to the systemic impact of untreated disease burden. This may include decreased mobility, reduction in overall health status, and increase of opioid use with the associated risks. METHODS: The article is the study of the American Society of Pain and Neuroscience (ASPN) COVID-19 task force to evaluate the policies set forth by federal, state, and local agencies to reduce or eliminate elective procedures for those patients with pain from spine, nerve, and joint disease. The impact of these decisions, which were needed to reduce the spread of the pandemic, led to a delay in care for many patients. We hence review an emergence plan to reinitiate this pain-related care. The goal is to outline a path to work with federal, state, and local authorities to combat the spread of the pandemic and minimize the deleterious impact of pain and suffering on our chronic pain patients. RESULTS: The article sets forth a strategy for the interventional pain centers to reemerge from the current pandemic and to set a course for future events. CONCLUSIONS: The COVID-19 pandemic represents an overwhelming challenge to interventional pain physicians and their patients. In addition to urgent actions needed for disease mitigation, the ASPN recommends a staged return to pain management professionals' workflow.


Assuntos
Betacoronavirus/patogenicidade , Dor Crônica/terapia , Infecções por Coronavirus/terapia , Procedimentos Clínicos , Manejo da Dor , Pneumonia Viral/terapia , Dor Crônica/diagnóstico , Dor Crônica/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Nível de Saúde , Humanos , Manejo da Dor/efeitos adversos , Pandemias , Segurança do Paciente , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Medição de Risco , Fatores de Risco , Resultado do Tratamento
20.
Surgery ; 168(3): 471-477, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32444065

RESUMO

BACKGROUND: Until now, no detailed long-term data regarding patients with declining quality of life or occupational status after laparoscopic Roux-en-Y gastric bypass surgery have been presented. The aim of this study was to evaluate the long-term effect of laparoscopic Roux-en-Y gastric bypass surgery on quality of life and occupational status. METHODS: The study was a single-center register-based cohort study including all patients who underwent laparoscopic Roux-en-Y gastric bypass surgery from 2010 through 2014. Quality of life was based on the validated Moorehead-Ardelt questionnaire, measured preoperatively and postoperatively after 12, 24, and median 63 months. Longitudinal trends of occupational status were created and compared with overall trends in the Danish population. Subgroup analyses were conducted, investigating associations between declining quality of life, declining occupational status, and postoperative chronic abdominal pain. RESULTS: In total, 749 patients were included in the study. All aspects of quality of life improved after laparoscopic Roux-en-Y gastric bypass surgery. After a median follow-up of 63 months, quality of life was significantly reduced in 14% of the patients compared with the preoperative baseline. Lower quality of life was associated with a decline in occupational status (P = .008) and postoperative chronic abdominal pain (P < .0001). Overall, occupational status was unchanged compared with before surgery. Throughout the study period occupational status declined in 21% of the patients. Declining occupational status was associated with declining quality of life (P = .008) and development of chronic abdominal pain (P = .009). CONCLUSION: In general, quality of life and occupational status improved after laparoscopic Roux-en-Y gastric bypass surgery. Subgroups of patients had declining quality of life and declining occupational status both being associated with postoperative chronic abdominal pain.


Assuntos
Emprego/estatística & dados numéricos , Derivação Gástrica/efeitos adversos , Laparoscopia/efeitos adversos , Obesidade Mórbida/cirurgia , Qualidade de Vida , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Adulto , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/etiologia , Estudos Prospectivos , Sistema de Registros/estatística & dados numéricos
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