Background
Methods
Study population and design
Diagnosis of herpes zoster
Pain intensity at presentation
Qualitative and quantitative diagnosis of Post Herpetic Neuralgia
Correlates of pain intensity at presentation and predictors of PHN
Data analysis
Results
Variables | Overall sample (n = 441) | PHN one-month definition (n = 226) | No PHN one-month definition (n = 210) |
P* | PHN three-month definition (n = 130) | No PHN three-month definition (n = 304) |
P* |
---|---|---|---|---|---|---|---|
Demographic characteristics
| |||||||
Mean age in years (SD) | 58.1 (20.4) | 61.1 (18.8) | 54.9 (21.7) | 0.002 | 60.4(19.3) | 57.0 (21.0) | 0.12 |
% | % | % | % | % | |||
Female gender | 56.5 | 57.5 | 55.4 | 0.6 | 60.0 | 54.7 | 0.3 |
Married | 76.4 | 79.6 | 73.2 | 0.10 | 83.1 | 73.3 | 0.02 |
Higher educational level | 39.7 | 38.9 | 40.5 | 0.7 | 39.2 | 40.1 | 0.9 |
Anamnesis
| |||||||
Hypertension | 36.0 | 39.4 | 32.6 | 0.14 | 33.8 | 36.8 | 0.7 |
Diabetes mellitus (missing = 3) | 9.1 | 10.7 | 7.5 | 0.2 | 8.6 | 9.1 | 0.9 |
HCV infection | 1.4 | 2.2 | 0.5 | 0.11 | 1.5 | 1.3 | 0.8 |
HIV infection | 1.1 | 1.8 | 0.5 | 0.2 | 1.5 | 1.0 | 0.6 |
Neoplasm (m = 8) | 11.3 | 12.7 | 9.9 | 0.3 | 10.0 | 11.4 | 0.9 |
Neurological disorders | 2.5 | 3.5 | 1.4 | 0.15 | 3.1 | 2.3 | 0.6 |
Psychiatric illnesses (m = 17) | 1.4 | 1.4 | 1.5 | 0.9 | 0.0 | 2.1 | 0.10 |
Allergy | 10.9 | 15.5 | 6.1 | 0.001 | 16.1 | 8.8 | 0.025 |
Trauma (m = 3) | 16.0 | 24.5 | 7.0 | < 0.001 | 31.8 | 9.5 | < 0.001 |
Surgical intervention (m = 3) | 31.0 | 41.5 | 20.1 | < 0.001 | 46.9 | 24.5 | < 0.001 |
Alcohol abuse (m = 7) | 6.9 | 4.5 | 9.5 | 0.04 | 4.0 | 7.9 | 0.14 |
Current or former smoking (m = 2) | 26.0 | 32.4 | 19.2 | 0.002 | 38.0 | 20.9 | < 0.001 |
Familial CHD risk (m = 2) | 25.1 | 29.9 | 20.0 | 0.017 | 31.2 | 22.2 | 0.045 |
Clinical characteristics
| |||||||
HZ dermatomeric district
| |||||||
Thoracic | 49.8 | 49.1 | 50.5 | 0.8 | 46.9 | 51.3 | 0.4 |
Lumbar | 22.9 | 23.4 | 22.4 | 0.8 | 25.4 | 21.2 | 0.3 |
Cranial | 18.2 | 20.8 | 15.4 | 0.14 | 19.2 | 18.0 | 0.8 |
Cervical | 9.1 | 6.6 | 11.7 | 0.07 | 8.5 | 9.5 | 0.7 |
Pain intensity
| |||||||
Mild | 40.5 | 30.1 | 51.6 | < 0.001 | 26.1 | 46.9 | < 0.001 |
Moderate | 34.2 | 33.6 | 34.7 | 0.8 | 31.5 | 35.4 | 0.4 |
Intense | 18.9 | 26.1 | 11.3 | < 0.001 | 30.0 | 13.8 | < 0.001 |
Very intense | 6.4 | 10.2 | 2.3 | < 0.001 | 12.3 | 3.9 | 0.001 |
> 50 vesicles (m = 163) | 30.2 | 37.1 | 22.0 | 0.007 | 38.4 | 26.8 | 0.054 |
Missed prescription of antivirals | 7.9 | 11.9 | 3.7 | 0.001 | 16.1 | 4.6 | < 0.001 |
Use of analgesics in the acute phase | 43.0 | 47.3 | 38.5 | 0.061 | 42.3 | 43.6 | 0.8 |
Correlates of pain intensity at presentation
Intense/Very intense pain (n = 111) | Mild/Moderate pain (n = 330) | OR (95% CI) |
P
| |
---|---|---|---|---|
Mean age in years (SD) | 65.4 (14.0) | 55.6 (21.7) | 1.02 (1.01 to 1.04)* | < 0.001 |
% | % | |||
Female gender | 69.4 | 52.1 | 2.50 (1.41 to 4.35) | 0.002 |
Current/former smoking | 33.3 | 23.5 | 2.00 (1.11 to 3.61) | 0.021 |
Trauma | 30.6 | 11.0 | 2.51 (1.30 to 4.84) | 0.006 |
Surgical intervention | 50.0 | 24.7 | 2.09 (1.21 to 3.62) | 0.008 |
Use of analgesics in the acute phase | 65.4 | 35.6 | 3.60 (2.17 to 5.98) | < 0.001 |
Predictors of PHN and overall pain burden
Variables | OR | (95% CI) |
P
|
---|---|---|---|
Age, ten-year increase | 1.01 | (1.00/1.02) | 0.017 |
Female gender | 0.91 | (0.63/1.32) | 0.6 |
Current/former smoking | 1.50 | (1.02/2.21) | 0.039 |
Intense/very intense pain at presentation | 1.85 | (1.29/2.65) | 0.001 |
Trauma | 2.27 | (1.48/3.46) | < 0.001 |
Surgical intervention | 1.40 | (0.96/2.02) | 0.081 |
Missed antiviral prescription | 1.46 | (1.00/2.25) | 0.049 |
Time, one-visit increase | 0.73 | (0.68/0.78) | < 0.001 |
PHN at one month | PHN at one to three months | |||||
---|---|---|---|---|---|---|
Variables | OR | (95% CI) |
P
| OR | (95% CI) |
P
|
Age, ten-year increase | 1.01 | (1.00 to 1.02) | 0.032 | 1.01 | (0.99 to 1.02) | 0.4 |
Female gender | 1.05 | (0.68 to 1.63) | 0.8 | 1.39 | (0.84 to 2.30) | 0.2 |
Current/former smoking | 1.62 | (0.98 to 2.67) | 0.061 | 2.08 | (1.22 to 3.55) | 0.007 |
Intense/very intense pain at presentation | 2.41 | (1.43 to 4.04) | 0.001 | 2.19 | (1.32 to 3.65) | 0.003 |
Trauma | 2.22 | (1.12 to 4.39) | 0.022 | 2.53 | (1.37 to 4.65) | 0.003 |
Surgical intervention | 1.60 | (0.98 to 2.63) | 0.062 | 1.33 | (0.79 to 2.25) | 0.3 |
Missed antiviral prescription | 2.01 | (1.01 to 4.46) | 0.047 | 2.28 | (1.04 to 4.98) | 0.038 |
Variables | Coefficient | (95% CI) |
P
|
---|---|---|---|
Age, 10-year increase | 0.03 | (0.01/0.05) | 0.004 |
Female gender | 0.68 | (-0.21/1.59) | 0.14 |
Current/former smoking | 1.50 | (0.47/2.53) | 0.004 |
Intense/very intense pain at presentation | 3.40 | (2.37/4.43) | < 0.001 |
Trauma | 1.58 | (0.31/2.85) | 0.015 |
Missed antiviral prescription | 2.22 | (0.63/3.82) | 0.006 |