Pain is a common problem affecting clinical outcomes in adults with cystic fibrosis

Margaret Hayes, Myron Yaster, Jennifer Haythornthwaite, Kristin Riekert, Kristen Nelson McMillan, Elizabeth White, Peter Mogayzel, Noah Lechtzin

Research output: Contribution to journalArticle

Abstract

Background: As the cystic fibrosis (CF) population has aged, many chronic health problems have emerged, including diabetes mellitus and osteoporosis. Previous studies have suggested that pain is common in patients with CF;however, little is known about the factors associated with it or its impact on clinical outcomes. We hypothesized that pain is common, is associated with psychologic distress, and adversely affects clinical outcomes. Methods: From February 1, 2008, to April 3, 2008, adults with CF from Johns Hopkins Hospital were surveyed about their pain. Outcomes were assessed for 12 months following survey completion. Bivariate analyses were performed using Wilcoxon log rank, Kruskal-Wallis tests, and Spearman correlations. Logistic regression models and Cox proportional hazard models were used to analyze clinical outcomes. Results: Eighty-three patients (61%) completed the survey. Eighty-two percent of patients reported pain within the past month, the most common sites being the head, sinuses, back, and chest. Pain frequently interfered with general activities (41.9%), mood (56.8%), and work (47.3%). Symptoms of depression and anxiety, as well as lower quality-of-life (QOL) scores, were associated with the presence of pain(P,.05 for each). The risk of pulmonary exacerbations was increased in patients with higher levels of pain, even after adjusting for FEV 1 and age (OR 5 1.65;P 5.038;95% CI, 1.03-2.64 ). Additionally, the risk of death was higher in patients with higher average pain scores (HR 5 2.28;P 5.008;95% CI 5 1.2-4.2). Conclusions: Pain is common in adults with CF, interferes with activities, and is associated with lower QOL and an increased risk of both exacerbations and death.

Original languageEnglish (US)
Pages (from-to)1598-1603
Number of pages6
JournalChest
Volume140
Issue number6
DOIs
StatePublished - Dec 2011

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Cystic Fibrosis
Pain
Logistic Models
Quality of Life
Proportional Hazards Models
Osteoporosis
Diabetes Mellitus
Thorax
Anxiety
Head
Depression
Lung
Health
Population

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Pain is a common problem affecting clinical outcomes in adults with cystic fibrosis. / Hayes, Margaret; Yaster, Myron; Haythornthwaite, Jennifer; Riekert, Kristin; McMillan, Kristen Nelson; White, Elizabeth; Mogayzel, Peter; Lechtzin, Noah.

In: Chest, Vol. 140, No. 6, 12.2011, p. 1598-1603.

Research output: Contribution to journalArticle

Hayes, Margaret ; Yaster, Myron ; Haythornthwaite, Jennifer ; Riekert, Kristin ; McMillan, Kristen Nelson ; White, Elizabeth ; Mogayzel, Peter ; Lechtzin, Noah. / Pain is a common problem affecting clinical outcomes in adults with cystic fibrosis. In: Chest. 2011 ; Vol. 140, No. 6. pp. 1598-1603.
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abstract = "Background: As the cystic fibrosis (CF) population has aged, many chronic health problems have emerged, including diabetes mellitus and osteoporosis. Previous studies have suggested that pain is common in patients with CF;however, little is known about the factors associated with it or its impact on clinical outcomes. We hypothesized that pain is common, is associated with psychologic distress, and adversely affects clinical outcomes. Methods: From February 1, 2008, to April 3, 2008, adults with CF from Johns Hopkins Hospital were surveyed about their pain. Outcomes were assessed for 12 months following survey completion. Bivariate analyses were performed using Wilcoxon log rank, Kruskal-Wallis tests, and Spearman correlations. Logistic regression models and Cox proportional hazard models were used to analyze clinical outcomes. Results: Eighty-three patients (61{\%}) completed the survey. Eighty-two percent of patients reported pain within the past month, the most common sites being the head, sinuses, back, and chest. Pain frequently interfered with general activities (41.9{\%}), mood (56.8{\%}), and work (47.3{\%}). Symptoms of depression and anxiety, as well as lower quality-of-life (QOL) scores, were associated with the presence of pain(P,.05 for each). The risk of pulmonary exacerbations was increased in patients with higher levels of pain, even after adjusting for FEV 1 and age (OR 5 1.65;P 5.038;95{\%} CI, 1.03-2.64 ). Additionally, the risk of death was higher in patients with higher average pain scores (HR 5 2.28;P 5.008;95{\%} CI 5 1.2-4.2). Conclusions: Pain is common in adults with CF, interferes with activities, and is associated with lower QOL and an increased risk of both exacerbations and death.",
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T1 - Pain is a common problem affecting clinical outcomes in adults with cystic fibrosis

AU - Hayes, Margaret

AU - Yaster, Myron

AU - Haythornthwaite, Jennifer

AU - Riekert, Kristin

AU - McMillan, Kristen Nelson

AU - White, Elizabeth

AU - Mogayzel, Peter

AU - Lechtzin, Noah

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N2 - Background: As the cystic fibrosis (CF) population has aged, many chronic health problems have emerged, including diabetes mellitus and osteoporosis. Previous studies have suggested that pain is common in patients with CF;however, little is known about the factors associated with it or its impact on clinical outcomes. We hypothesized that pain is common, is associated with psychologic distress, and adversely affects clinical outcomes. Methods: From February 1, 2008, to April 3, 2008, adults with CF from Johns Hopkins Hospital were surveyed about their pain. Outcomes were assessed for 12 months following survey completion. Bivariate analyses were performed using Wilcoxon log rank, Kruskal-Wallis tests, and Spearman correlations. Logistic regression models and Cox proportional hazard models were used to analyze clinical outcomes. Results: Eighty-three patients (61%) completed the survey. Eighty-two percent of patients reported pain within the past month, the most common sites being the head, sinuses, back, and chest. Pain frequently interfered with general activities (41.9%), mood (56.8%), and work (47.3%). Symptoms of depression and anxiety, as well as lower quality-of-life (QOL) scores, were associated with the presence of pain(P,.05 for each). The risk of pulmonary exacerbations was increased in patients with higher levels of pain, even after adjusting for FEV 1 and age (OR 5 1.65;P 5.038;95% CI, 1.03-2.64 ). Additionally, the risk of death was higher in patients with higher average pain scores (HR 5 2.28;P 5.008;95% CI 5 1.2-4.2). Conclusions: Pain is common in adults with CF, interferes with activities, and is associated with lower QOL and an increased risk of both exacerbations and death.

AB - Background: As the cystic fibrosis (CF) population has aged, many chronic health problems have emerged, including diabetes mellitus and osteoporosis. Previous studies have suggested that pain is common in patients with CF;however, little is known about the factors associated with it or its impact on clinical outcomes. We hypothesized that pain is common, is associated with psychologic distress, and adversely affects clinical outcomes. Methods: From February 1, 2008, to April 3, 2008, adults with CF from Johns Hopkins Hospital were surveyed about their pain. Outcomes were assessed for 12 months following survey completion. Bivariate analyses were performed using Wilcoxon log rank, Kruskal-Wallis tests, and Spearman correlations. Logistic regression models and Cox proportional hazard models were used to analyze clinical outcomes. Results: Eighty-three patients (61%) completed the survey. Eighty-two percent of patients reported pain within the past month, the most common sites being the head, sinuses, back, and chest. Pain frequently interfered with general activities (41.9%), mood (56.8%), and work (47.3%). Symptoms of depression and anxiety, as well as lower quality-of-life (QOL) scores, were associated with the presence of pain(P,.05 for each). The risk of pulmonary exacerbations was increased in patients with higher levels of pain, even after adjusting for FEV 1 and age (OR 5 1.65;P 5.038;95% CI, 1.03-2.64 ). Additionally, the risk of death was higher in patients with higher average pain scores (HR 5 2.28;P 5.008;95% CI 5 1.2-4.2). Conclusions: Pain is common in adults with CF, interferes with activities, and is associated with lower QOL and an increased risk of both exacerbations and death.

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