老年患者慢性疼痛风险预测模型的构建  

Construction of risk prediction model for chronic pain in elderly patients

作　　者：王婷婷[1] 朱彤[1] 宁本翔[1] 徐金[1] Wang Tingting;Zhu Tong;Ning Benxiang;Xu Jin(Pain Department,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院疼痛科,南京210008

出　　处：《中华现代护理杂志》2022年第34期4773-4778,共6页Chinese Journal of Modern Nursing

摘　　要：目的:构建老年患者慢性疼痛风险预测模型,并验证其预测价值。方法:采用便利抽样法,选取2020年1月-2021年6月南京大学医学院附属鼓楼医院疼痛科收治的320例老年患者为研究对象。收集患者一般资料,按照患者是否存在慢性疼痛将其分为慢性疼痛组( n=185)和非慢性疼痛组( n=135)。采用数字评分量表(NRS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数评分量表、成人跌倒风险评估量表、便秘症状及疗效评估量表、生物电阻抗法对患者进行调查。采用二项Logistic回归分析探讨老年患者产生慢性疼痛的危险因素并建立风险预测模型。采用受试者工作特征曲线(ROC)对风险预测模型的预测能力进行评价。 结果:185例老年慢性疼痛患者NRS评分为(4.34±1.50)分;下肢、腰骶、颈部为慢性疼痛最常见部位;骨关节炎、颈椎病是引起患者慢性疼痛的主要疾病类型。二项Logistic回归分析结果显示,高SDS评分、高成人跌倒风险评估量表评分、高便秘症状评分、高SAS评分以及低四肢骨骼肌指数是老年患者出现慢性疼痛的独立危险因素( P<0.05)。老年患者慢性疼痛风险预测模型的ROC曲线下面积为0.878,敏感度为92.53%,特异度为67.04%。 结论:基于焦虑、抑郁、跌倒、肌少症、便秘的多评估指标建立的风险预测模型对老年患者慢性疼痛的预测具有较好临床应用价值,能够为老年患者慢性疼痛的早期识别和干预提供支持。Objective To construct a risk prediction model for chronic pain in elderly patients and verify its predictive value.Methods From January 2020 to June 2021,320 elderly patients admitted to the Pain Department of Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School were selected by convenience sampling.The general information of patients was collected,and patients were divided into chronic pain group(n=185)and non-chronic pain group(n=135)according to whether they had chronic pain.The patients were investigated with the Numerical Rating Scale(NRS),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI),Morse Fall Scale,Constipation Symptom and Efficacy Scale,and bioelectrical impedance method.The binomial Logistic regression analysis was used to explore the risk factors of chronic pain in elderly patients and establish a risk prediction model.The predictive value of the risk prediction model was evaluated by the receiver operating characteristic(ROC)curve.Results The NRS score of 185 patients with chronic pain was(4.34±1.50).Lower limbs,lumbosacral region and neck were the most common parts of chronic pain.Osteoarthritis and cervical spondylosis were the main diseases causing chronic pain.Binomial Logistic regression analysis showed that high SDS score,high Morse Fall Scale score,high constipation symptom score,high SAS score and low appendicular skeletal muscle mass index were independent risk factors for chronic pain in elderly patients(P<0.05).The area under the ROC curve of the risk prediction model for chronic pain in elderly patients was 0.878,the sensitivity was 92.53%,and the specificity was 67.04%.Conclusions The risk prediction model based on anxiety,depression,falls,myasthenia and constipation has good clinical value in predicting chronic pain in elderly patients,and can provide support for early identification and intervention of chronic pain in elderly patients.

关 键 词：老年人 预测模型 慢性疼痛 危险因素 

分 类 号：R402[医药卫生—临床医学]