Prognostic indicators for non-recovery of non-traumatic complaints at arm, neck and shoulder in general practice-6 months follow-up

被引:49
作者
Feleus, A.
Bierma-Zeinstra, S. M. A.
Miedema, H. S.
Verhagen, A. P.
Nauta, A. P.
Burdorf, A.
Verhaar, J. A. N.
Koes, B. W.
机构
[1] Erasmus MC, Dept Gen Practice, NL-3000 DR Rotterdam, Netherlands
[2] Erasmus MC, Netherlands Expert Ctr Workrelated Musculoskeleta, NL-3000 DR Rotterdam, Netherlands
[3] Erasmus MC, Dept Orthopaed, NL-3000 DR Rotterdam, Netherlands
[4] Erasmus MC, Dept Publ Hlth, NL-3000 DR Rotterdam, Netherlands
[5] Netherlands Soc Occupat Med, Ctr Excellence, Utrecht, Netherlands
关键词
arm; neck; shoulder; prognosis; primary care;
D O I
10.1093/rheumatology/kel164
中图分类号
R5 [内科学];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
Objectives. To identify predictors of non-recovery in non-traumatic complaints at the arm, neck and shoulder in general practice 6 months after the first consultation. Methods. A prospective cohort study was set in 21 Dutch general practices. Consulters with a first or new episode of non-traumatic arm, neck or shoulder complaints and age 18 through 64 yrs entered the cohort. Complaint, patient, physical, psychosocial and work characteristics were investigated as possible predictors of non-recovery at 6 months using multiple logistic regression analyses (backward Wald). Results. At 6 months, 46% of the total population (n = 612) and 42% of the working subpopulation (n = 473) still reported complaints. Complaint characteristics (long duration of the complaint before consultation, recurrent complaint, musculoskeletal comorbidity and complaint mainly located at wrist or hand) were most predictive of non-recovery followed by psychosocial characteristics (more somatization and experiencing less social support). Having a specific diagnosis was associated with recovery. In the working subpopulation, the same variables were predictors of non-recovery. Additionally, low supervisory support was associated with non-recovery. The models correctly classified 72-75% of the patients (explained variance 0.27-0.28). Conclusions. Besides questions on complaint characteristics, information on somatization and support can help a general practitioner to recognize patients at risk of persistent complaints.
引用
收藏
页码:169 / 176
页数:8
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