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Mortality among immigrant patients 20-45 years of age with chronic back pain in primary care in Sweden: A 15-year follow-up cohort study.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0001-7761-6282
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0003-3691-8326
2019 (English)In: Journal of Back and Musculoskeletal Rehabilitation, ISSN 1053-8127, E-ISSN 1878-6324Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Mortality rates among immigrant patients undergoing rehabilitation for musculoskeletal backache are unknown.

OBJECTIVE: To study the association between marital status, severe psychosocial strain, receiving long-term time-limited sickness allowance (TLSA) and all-cause mortality (ACM) in a cohort of immigrants aged 20-45 years with long-standing backache in Sweden.

METHODS: We studied 318 patients (92% foreign-born, 76% non-European) of known marital status on sick-leave for musculoskeletal backache. They were followed up for ACM until 2015. Socio-demographic data, TLSA and psychosocial strain, including major depression, severe psychosocial stressors and pessimistic thoughts, were analysed using multiple-imputation Cox regression.

RESULTS: Over a mean (standard deviation) follow-up time of 15 (5.0) years, 11 (3.5%) participants died. At baseline, 34% were unmarried, 19% were receiving TLSA, and 71% had ⩾ 1 psychosocial strain component (38% depression; 47% severe stressors; 35% pessimistic thoughts). After concomitant risk factors were adjusted for, being unmarried and receiving TLSA were associated with higher mortality by factors of 6.2 (p= 0.005) and 5.8 (p= 0.006), respectively. Psychosocial strain was only significantly associated with higher mortality in the unadjusted analyses.

CONCLUSIONS: Being unmarried and receiving TLSA were associated with significantly higher ACM in this highly marginalized group of immigrant patients.

Place, publisher, year, edition, pages
2019.
Keywords [en]
Chronic pain, all-cause mortality, depression, illness attitudes, immigrants, primary care, psychosocial stressors, rehabilitation, sickness allowance
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-402740DOI: 10.3233/BMR-181273PubMedID: 31903979OAI: oai:DiVA.org:uu-402740DiVA, id: diva2:1386671
Available from: 2020-01-18 Created: 2020-01-18 Last updated: 2020-01-30Bibliographically approved

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Löfvander, MonicaRosenblad, Andreas

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Family Medicine and Preventive MedicineCentre for Clinical Research, County of Västmanland
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