Coccydynia – may age, trauma and physique mass index be unbiased prognostic components for outcomes of intervention?
Ann R Coll Surg Engl. 2018 Jan;100(1):12-15
Authors: Kodumuri P, Raghuvanshi S, Bommireddy R, Klezl Z
Introduction The aetiology of coccydynia might be multifactorial, with a number of related components equivalent to weight problems, feminine gender and low temper. The long-term outcomes of operative interventions, equivalent to manipulation below anaesthesia and coccygectomy are variable, starting from 63-90%. Supplies and strategies Our intention was to determine whether or not age, trauma and physique mass index (BMI) have been unbiased prognostic components in coccydynia remedy. All sufferers who introduced to the Royal Derby Hospital with a major prognosis of coccydynia between January 2011 and January 2015 who had injections, manipulation below anaesthesia or coccygectomy have been included. We used patient-reported satisfaction rating as the first consequence measure. We hypothesised that sufferers with previous historical past of trauma and with excessive BMI (> 25) could be much less happy. We divided affected person BMI into 4 teams, following World Well being Group tips: group A (18.5-24.9), group B (25-29.9), group C (30-39.9) and group D (> 40). Outcomes A complete of 748 sufferers have been identified with coccydynia. Of those, 201 sufferers had 381 injections, 40 had 98 manipulations below anaesthesia and 9 had coccygectomy. Imply age was 46.four years; 26% of sufferers had trauma to the coccyx. The imply time to follow-up was 7.three months. We discovered a statistically vital distinction (P = zero.03) between satisfaction scores in teams B and D. Sufferers who had trauma improved considerably (P = zero.04). The percentages ratio calculation of coccygectomy and BMI revealed a better threat of coccygectomy in Group A. Dialogue That is the primary research to determine BMI and trauma as unbiased prognostic components for coccydynia remedy. Our speculation that sufferers with larger BMI would have decrease satisfaction ranges has been confirmed true.
PMID: 29260897 [PubMed – indexed for MEDLINE]