Long-term outcomes of a large, prospective observational cohort of older adults with back pain
Recommended Citation
Jarvik JG, Gold LS, Tan K, Friedly JL, Nedeljkovic SS, Comstock BA, Deyo RA, Turner JA, Bresnahan BW, Rundell SD, James KT, Nerenz DR, Avins AL, Bauer Z, Kessler L, Heagerty PJ. Long-term outcomes of a large, prospective observational cohort of older adults with back pain. The spine journal 2018; 18(9):1540-1551.
Document Type
Article
Publication Date
9-2018
Publication Title
The spine journal
Abstract
BACKGROUND CONTEXT: Although back pain is common among older adults, there is relatively little research on the course of back pain in this age group.
PURPOSE: Our primary goals were to report 2-year outcomes of older adults initiating primary care for back pain and to examine the relative importance of patient factors versus medical interventions in predicting 2-year disability and pain.
STUDY DESIGN/SETTING: This study used a predictive model using data from a prospective, observational cohort from a primary care setting.
PATIENT SAMPLE: The study included patients aged ≥65 years at the time of new primary care visits for back pain.
OUTCOME MEASURES: Self-reported 2-year disability (Roland-Morris Disability Questionnaire [RDQ]) and back pain (0-10 numerical rating scale [NRS]).
METHODS: We developed our models using a machine learning least absolute shrinkage and selection operator approach. We evaluated the predictive value of baseline characteristics and the incremental value of interventions that occurred between 0 and 90 days, and the change in patient disability and pain from 0 to 90 days. Limitations included confounding by indication and unmeasured confounding.
RESULTS: Of 4,665 patients (89%) with follow-up, both RDQ (from mean 9.6 [95% confidence interval {CI} 9.4-9.7] to mean 8.3 [95% CI 8.0-8.5]) and back pain NRS (from mean 5.0 [95% CI 4.9-5.1] to mean 3.5 [95% CI 3.4-3.6]) scores improved slightly. Only 16% (15%-18%) reported no back pain-related disability or back pain at 2 years after initial visits. Regression model parameters explained 40% of the variation (R
CONCLUSIONS: Baseline patient factors were more important than early interventions in explaining disability and pain after 2 years.
PubMed ID
29391206
Volume
18
Issue
9
First Page
1540
Last Page
1551
