| Title: | Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis |
| Journal: | EClinicalMedicine |
| Published: | 14 Nov 2021 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/34825152/ |
| DOI: | https://doi.org/10.1016/j.eclinm.2021.101202 |
| URL: | http://www.thelancet.com/article/S2589537021004831/pdf |
Publication 7436
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Abstract
BACKGROUND: We aimed to quantify the association between chronic musculoskeletal pain and all-cause mortality, and to investigate the extent to which this association is mediated by physical activity, smoking status, alcohol consumption, and opioid use.METHODS: For this population-based cohort study, we used data from UK Biobank, UK between baseline visit (2006-2010) to 18th December 2020. We assessed the associations between chronic musculoskeletal pain and all-cause mortality using a Cox proportional hazards model. We performed causal mediation analyses to examine the proportion of the association between chronic musculoskeletal pain and all-cause mortality.
FINDINGS: Of the 384,367 included participants, a total of 187,269 participants reported chronic musculoskeletal pain. Higher number of pain sites was associated with increased risk of all-cause mortality compared to having no pain (e.g., four sites vs no site of pain, Hazard Ratio [HR] 1.46, 95% Confidence Interval [CI] 1.35 to 1.57). The multiple mediator analyses showed that the mediating proportions of all four mediators ranged from 53.4% to 122.6%: among participants with two or more pain sites, the effect estimate reduced substantially, for example, HR reduced from 1.25 (95% CI: 1.21 to 1.30; two pain sites) to 1.07 (95% CI: 1.01 to 1.11; two pain sites).
INTERPRETATION: We found that higher number of pain sites was associated with increased risk of all-cause mortality compared to having no pain, and at least half of the association of chronic musculoskeletal pain with increased all-cause mortality may be accounted for by four mediators.
FUNDING: Twins Research Australia.
11 Authors
- Lingxiao Chen
- Manuela L Ferreira
- Natasha Nassar
- David B Preen
- John L Hopper
- Shuai Li
- Minh Bui
- Paula R Beckenkamp
- Baoyi Shi
- Nigel K Arden
- Paulo H Ferreira
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