Poor prognostic factors in complex regional pain syndrome 1: A Delphi survey
Florian Brunner, Mara Nauer, Lucas M. Bachmann
Objective: A major challenge in the management of patients with complex regional pain syndrome 1 is identifying those individuals who are at risk of developing severe problems. Data from large follow-up studies providing empirical evidence are largely lacking. The goal of this study was to obtain an expert-agreed priority list of parameters that are correlated with a poor prognosis.
Methods: In a two-round Delphi survey, experts were asked to list those parameters that they considered to be strongly associated with a poor prognosis (first round) and to weight parameters that they believed to be most relevant for poor prognosis (second round). Median ratings and interquartile ranges were calculated. Rates > 7 and interquartile ranges < 3 depicted important and expert-agreed parameters.
Results: Thirty-nine experts compiled a list of 254 items. Twenty-eight experts reached a consensus on 49 important items associated with poor prognosis. They primarily agreed on clinical manifestations of complex regional pain syndrome 1. Psychosocial factors were considered less important.
Conclusion: The findings of this study indicate that poor prognosis for complex regional pain syndrome 1 is primarily dependent on clinical manifestations. While evidence suggests that psychosocial factors may play a role in the development of the condition, their role in poor prognosis appears to be less important.
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