Relationship Between Persistent Pain and 5-Year Mortality: A Population-Based Prospective Cohort Study

• Autores: Joseph W. Shega, Melissa Andrew, Ashwin Kotwal, Denys T. Lau, Keela Herr, Mary Ersek, Debra K. Weiner, Marshall H. Chin, William Dale
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 12, 2013, págs. 2135-2141
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Objectives: To assess the association between self-reported noncancer pain and 5-year mortality.

    Design: Cohort.

    Setting: Community-dwelling older adults.

    Participants: Canadian Study of Health and Aging 1996 wave.

    Measurements: Registrar of Vital Statistics�established 5-year mortality. Noncancer pain was assessed using the 5-point verbal descriptor scale, dichotomized into no or very mild versus moderate, severe, or very severe pain. Frailty was the accumulation of health deficits. Cognitive status (Modified Mini-Mental State Examination) and depressed mood (five-item mental health screening questionnaire) were also assessed. Multivariable logistic regression and Cox proportional hazards were used to analyze the relationship between pain and 5-year mortality.

    Results: Of 5,703 participants, 4,694 (82.3%) had complete data for analysis; 1,663 of these (35.4%) reported moderate, severe, or very severe pain, and 1,343 (28.6%) had died at 5-year follow-up. Four hundred ninety-six of those who died (29.8%) reported moderate, severe, or very severe pain and 847 (27.9%) no or very mild pain. Multivariate logistic analysis found that individuals with moderate, severe, or very severe pain had lower odds of 5-year mortality than those with no or very mild pain (odds ratio = 0.78, 95% confidence interval (CI) = 0.66�0.92; P < .001). The risk of death was lower in persons reporting moderate or greater pain than in those with no or very mild pain (HR = 0.85, 95% CI = 0.75�0.96; P = .01). An interaction between pain and sex explained this effect. Men with pain were not significantly more likely than men without pain to die (HR = 1.00, 95% CI = 0.84�1.19; P = .99), whereas women without pain (HR = 0.54, 95% CI = 0.47�0.63; P < 0.01) and women with pain (HR = 0.40; CI = 0.33�0.47; P < .01) had less risk of death than men without and with pain, respectively.

    Conclusion: Older women with pain were less likely to die within 5 years than older women without pain, men in pain, or men without pain.