Cargando…

Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study

Objective To estimate the one year prognosis and identify prognostic factors in cases of recent onset low back pain managed in primary care. Design Cohort study with one year follow-up. Setting Primary care clinics in Sydney, Australia. Participants An inception cohort of 973 consecutive primary car...

Descripción completa

Detalles Bibliográficos
Autores principales: Henschke, Nicholas, Maher, Christopher G, Refshauge, Kathryn M, Herbert, Robert D, Cumming, Robert G, Bleasel, Jane, York, John, Das, Anurina, McAuley, James H
Formato: Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483884/
https://www.ncbi.nlm.nih.gov/pubmed/18614473
http://dx.doi.org/10.1136/bmj.a171
_version_ 1782158068932411392
author Henschke, Nicholas
Maher, Christopher G
Refshauge, Kathryn M
Herbert, Robert D
Cumming, Robert G
Bleasel, Jane
York, John
Das, Anurina
McAuley, James H
author_facet Henschke, Nicholas
Maher, Christopher G
Refshauge, Kathryn M
Herbert, Robert D
Cumming, Robert G
Bleasel, Jane
York, John
Das, Anurina
McAuley, James H
author_sort Henschke, Nicholas
collection PubMed
description Objective To estimate the one year prognosis and identify prognostic factors in cases of recent onset low back pain managed in primary care. Design Cohort study with one year follow-up. Setting Primary care clinics in Sydney, Australia. Participants An inception cohort of 973 consecutive primary care patients (mean age 43.3, 54.8% men) with non-specific low back pain of less than two weeks’ duration recruited from the clinics of 170 general practitioners, physiotherapists, and chiropractors. Main outcome measures Participants completed a baseline questionnaire and were contacted six weeks, three months, and 12 months after the initial consultation. Recovery was assessed in terms of return to work, return to function, and resolution of pain. The association between potential prognostic factors and time to recovery was modelled with Cox regression. Results The follow-up rate over the 12 months was more than 97%. Half of those who reduced their work status at baseline had returned to previous work status within 14 days (95% confidence interval 11 to 17 days) and 83% had returned to previous work status by three months. Disability (median recovery time 31 days, 25 to 37 days) and pain (median 58 days, 52 to 63 days) took much longer to resolve. Only 72% of participants had completely recovered 12 months after the baseline consultation. Older age, compensation cases, higher pain intensity, longer duration of low back pain before consultation, more days of reduced activity because of lower back pain before consultation, feelings of depression, and a perceived risk of persistence were each associated with a longer time to recovery. Conclusions In this cohort of patients with acute low back pain in primary care, prognosis was not as favourable as claimed in clinical practice guidelines. Recovery was slow for most patients. Nearly a third of patients did not recover from the presenting episode within a year.
format Text
id pubmed-2483884
institution National Center for Biotechnology Information
language English
publishDate 2008
publisher BMJ Publishing Group Ltd.
record_format MEDLINE/PubMed
spelling pubmed-24838842008-07-28 Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study Henschke, Nicholas Maher, Christopher G Refshauge, Kathryn M Herbert, Robert D Cumming, Robert G Bleasel, Jane York, John Das, Anurina McAuley, James H BMJ Research Objective To estimate the one year prognosis and identify prognostic factors in cases of recent onset low back pain managed in primary care. Design Cohort study with one year follow-up. Setting Primary care clinics in Sydney, Australia. Participants An inception cohort of 973 consecutive primary care patients (mean age 43.3, 54.8% men) with non-specific low back pain of less than two weeks’ duration recruited from the clinics of 170 general practitioners, physiotherapists, and chiropractors. Main outcome measures Participants completed a baseline questionnaire and were contacted six weeks, three months, and 12 months after the initial consultation. Recovery was assessed in terms of return to work, return to function, and resolution of pain. The association between potential prognostic factors and time to recovery was modelled with Cox regression. Results The follow-up rate over the 12 months was more than 97%. Half of those who reduced their work status at baseline had returned to previous work status within 14 days (95% confidence interval 11 to 17 days) and 83% had returned to previous work status by three months. Disability (median recovery time 31 days, 25 to 37 days) and pain (median 58 days, 52 to 63 days) took much longer to resolve. Only 72% of participants had completely recovered 12 months after the baseline consultation. Older age, compensation cases, higher pain intensity, longer duration of low back pain before consultation, more days of reduced activity because of lower back pain before consultation, feelings of depression, and a perceived risk of persistence were each associated with a longer time to recovery. Conclusions In this cohort of patients with acute low back pain in primary care, prognosis was not as favourable as claimed in clinical practice guidelines. Recovery was slow for most patients. Nearly a third of patients did not recover from the presenting episode within a year. BMJ Publishing Group Ltd. 2008-07-19 /pmc/articles/PMC2483884/ /pubmed/18614473 http://dx.doi.org/10.1136/bmj.a171 Text en © BMJ Publishing Group Ltd 2008
spellingShingle Research
Henschke, Nicholas
Maher, Christopher G
Refshauge, Kathryn M
Herbert, Robert D
Cumming, Robert G
Bleasel, Jane
York, John
Das, Anurina
McAuley, James H
Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study
title Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study
title_full Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study
title_fullStr Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study
title_full_unstemmed Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study
title_short Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study
title_sort prognosis in patients with recent onset low back pain in australian primary care: inception cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483884/
https://www.ncbi.nlm.nih.gov/pubmed/18614473
http://dx.doi.org/10.1136/bmj.a171
work_keys_str_mv AT henschkenicholas prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT maherchristopherg prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT refshaugekathrynm prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT herbertrobertd prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT cummingrobertg prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT bleaseljane prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT yorkjohn prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT dasanurina prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy
AT mcauleyjamesh prognosisinpatientswithrecentonsetlowbackpaininaustralianprimarycareinceptioncohortstudy