Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis

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 stud...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/761466a427aa4802b21a154667c9be59
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spelling	oai:doaj.org-article:761466a427aa4802b21a154667c9be592021-11-16T04:11:03ZAssociation of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis2589-537010.1016/j.eclinm.2021.101202https://doaj.org/article/761466a427aa4802b21a154667c9be592021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589537021004831https://doaj.org/toc/2589-5370Background: 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.Lingxiao ChenManuela L FerreiraNatasha NassarDavid B PreenJohn L HopperShuai LiMinh BuiPaula R BeckenkampBaoyi ShiNigel K ArdenPaulo H FerreiraElsevierarticleMedicine (General)R5-920ENEClinicalMedicine, Vol 42, Iss , Pp 101202- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 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 Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis
description	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.
format	article
author	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
author_facet	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
author_sort	Lingxiao Chen
title	Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis
title_short	Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis
title_full	Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis
title_fullStr	Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis
title_full_unstemmed	Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis
title_sort	association of chronic musculoskeletal pain with mortality among uk adults: a population-based cohort study with mediation analysis
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/761466a427aa4802b21a154667c9be59
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Association of chronic musculoskeletal pain with mortality among UK adults: A population-based cohort study with mediation analysis

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