Table 4 |
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Significant Prognostic Factors identified in all included studies |
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ID |
First Author |
Statistical analysis |
Outcomes measured |
Statistically significanta predictors of poor outcome |
Strength of association |
Statistically significanta predictors of good outcome |
Strength of association |
Comments |
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1 |
Balague [12] |
Multivariate analysis (stepwise logistic regression) |
"Recovery" (composite score including pain, disability & muscle strength) Recovery defined as: ODI Score ≤ 20 VAS pain ≤ 15 Normal muscle strength test (score 5) |
Positive neurological examination (Neurotot) |
OR 4.3 (95%CI; 1.37, 13.28) |
It is unclear whether the odds ratio given is crude or adjusted. |
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2 |
Beauvais [13] |
Recovery and failure groups compared using Fishers test, Chi squared test or Wilcoxon test |
"Recovery" Complete = return to usual work/activities, little or no analgesia Partial = residual pain, frequent analgesic use, complete or partial return to work, limited athletic activities Failure = persistent pain, continuous analgesic use, unable to return to work |
Hospital admission because of severity of sciatic pain |
Not reported |
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3 |
Carragee [14] |
Multivariate analysis (multiple logistic regression) |
Composite measure of overall outcome comprising sum of scores on 0-10 scale for self-reported pain, medication use, activity restriction and satisfaction, total divided by 4 to give outcome score > 6 = good ≤6 = poor |
Larger ratio of disc to remaining canal (in conservatively treated patients) |
R = 0.50 |
Shorter duration of symptoms Absence of litigation Younger age |
Not reported |
Data from surgically and non-surgically treated patients analysed separately. Only data from conservatively treated patients presented |
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4 |
Hasenbring [15] |
Multivariate regression analysis |
Pain Intensity Self report 8 point scale |
Lesser degree of disc displacement Scoliosis High score for non-verbal pain behaviour Low score for direct search for social support Tendency to ignore pain experience Poor ability to imagine coping with the pain Low social status |
β = -0.32 β = 0.15 β = 0.31 β = -0.35 β = 0.29 β = -0.20 β = -0.17 |
Pain intensity was the only outcome studied. 73 (65.8%) underwent surgical treatment but the analysis adjusted for treatment which was not found to be a significant predictor in this study. |
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5 |
Jensen [16] |
Multivariate analysis adjusted for age, sex and treatment |
"Recovery" (composite score including pain on 11 point VRS & disability on RMDQ) Recovery defined as: Pain score < 1 & RMDQ ≤ 3 |
Broad based disc protrusion Disc extrusion Male gender Absence of canal stenosis (males only) |
OR 13.6 (95% CI; 1.9, 95.4) OR 10.6 (95% CI; 1.9, 58.7) OR 2.6 (95% CI; 1.3, 5.0) OR 4.2 (95% CI; 1.2, 14.7) |
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6 |
Komori [17] |
Non-parametric methods (not further specified) |
Outcome defined according to residual self-reported symptoms and disability on 3 point scale (poor, fair, good) |
Smaller herniated disc Greater symptom severity at initial assessment |
Not reported |
The findings of this study should be interpreted with caution due to poor methodological quality |
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7 |
Miranda [19] |
Multivariate logistic regression |
Outcome defined as persistence of pain based on self report of sciatic pain Persistence = sciatica pain on >30 days/year in 2 consecutive years (1994 & 1995) on modified NMQ) |
Poor job satisfaction Ex-smoker Jogging |
OR 2.8 (95% CI; 1.2,6.7) OR 2.3 (95% CI; 1.3,4.3) OR 3.9 ( 95% CI;1.4,10.7) |
Diagnosis of sciatica based on self-reported symptoms only |
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8 |
Vroomen [18] |
Multivariate logistic regression |
Poor outcome defined as absence of any improvement at 3 months based on self-reported change in symptoms |
Duration of pain > 30 days Positive SLR |
OR 10 (95%CI;2.5,33.3)* OR 2.5 (95%CI;1.25,20)* * see footnote |
Patients undergoing eventual surgery excluded from this analysis. Follow up period only 3 months. |
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* We have recalculated the odds ratios for poor outcome from the original report of the analysis of patients treated conservatively throughout p < 0.05 |
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Ashworth et al. BMC Musculoskeletal Disorders 2011 12:208 doi:10.1186/1471-2474-12-208 |
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