Increased Incidence of Depression and Chronic Pain in Traumatic Spinal Cord Injury Patients With Pre-Injury Alcohol Use Disorder: Longitudinal Analysis of Insurance Claim Database.

IF 1.8 Q3 CLINICAL NEUROLOGY Neurotrauma reports Pub Date : 2024-01-12 eCollection Date: 2024-01-01 DOI:10.1089/neur.2023.0096
Beatrice Ugiliweneza, Dengzhi Wang, Benjamin Rood, Maxwell Boakye, Camilo Castillo, Michal Hetman
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Abstract

Alcohol use disorder (AUD) increases risk of traumatic spinal cord injury (SCI) and is associated with depression, anxiety, and chronic pain. Given that these neuropsychiatric morbidities are frequently observed in SCI patients, the effects of pre-injury AUD on risk of depression, anxiety, or chronic pain were analyzed using an insurance claim database. Of 10,591 traumatic SCI patients, 507 had AUD-associated claims in a 12-month period before injury. Those AUD-positive SCI patients showed distinct demographic characteristics, including greater representation of men, younger age, more comorbidities, lower coverage by commercial insurance, and more cervical-level injuries. The AUD group also showed elevated pre-injury comorbidity of depression, anxiety, and chronic pain. However, multi-regression analysis revealed an increased odds ratio (OR) of de novo diagnosis of post-SCI depression in AUD patients 6 months (1.671; 95% confidence interval [CI]: 1.124, 2.483) and 1 year post-injury (1.511; 95% CI: 1.071, 2.131). The OR of de novo post-SCI anxiety was unaffected by pre-injury AUD. Finally, 1 year after SCI, pre-injury AUD increased the OR of de novo diagnosis of post-injury chronic pain (1.545; 95% CI: 1.223, 1.951). Thus, pre-injury AUD may be a risk factor for development of depression and chronic pain after traumatic SCI.

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创伤性脊髓损伤患者在受伤前酗酒导致抑郁和慢性疼痛的发生率增加:保险索赔数据库纵向分析》。
酒精使用障碍(AUD)会增加外伤性脊髓损伤(SCI)的风险,并与抑郁、焦虑和慢性疼痛有关。鉴于 SCI 患者中经常出现这些神经精神疾病,我们利用保险理赔数据库分析了受伤前 AUD 对抑郁、焦虑或慢性疼痛风险的影响。在 10,591 名外伤性 SCI 患者中,有 507 人在受伤前的 12 个月内与 AUD 相关。这些 AUD 阳性的 SCI 患者表现出明显的人口统计学特征,包括男性比例更高、年龄更小、合并症更多、商业保险覆盖率更低、颈椎水平损伤更多。AUD 组还表现出较高的伤前合并症,如抑郁、焦虑和慢性疼痛。然而,多元回归分析显示,AUD 患者在受伤后 6 个月(1.671;95% 置信区间 [CI]:1.124, 2.483)和 1 年(1.511;95% 置信区间:1.071, 2.131)被重新诊断为 SCI 后抑郁症的几率比(OR)增加。损伤后新焦虑的 OR 值不受损伤前 AUD 的影响。最后,在 SCI 一年后,受伤前 AUD 增加了受伤后慢性疼痛新诊断的 OR 值(1.545;95% CI:1.223, 1.951)。因此,受伤前的 AUD 可能是创伤性 SCI 后抑郁和慢性疼痛发展的风险因素。
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审稿时长
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