Dolor en adolescentes y sus factores de riesgo: estudio de casos y controles

Agüero, Gonzalo; Salmain, Soledad; Manzur, Belén; Berner, Enrique

Introducción. Los síndromes dolorosos más comunes (cefalea, dolor abdominal y dolor musculoesquelético) aparecen o empeoran durante la adolescencia, y son frecuente motivo de consulta. Objetivo. Evaluar la asociación de edad, sexo, obesidad, desarrollo puberal, nivel de escolarización, trabajo y constitución familiar con la consulta por dolor en adolescentes. Población y métodos. Estudio de casos y controles realizado entre el 1/2/14 y el 30/6/15.

Criterios de inclusión:

edad 10 a 20 años, ambos sexos, consultaron por dolor (casos) o para control de salud y/o apto físico escolar (controles). Se utilizaron los test de chi² y de Student. Se calcularon Odds Ratios (OR). Se construyó un modelo de regresión logística binaria para evaluar independientemente cada variable asociada con dolor. Resultados. Se evaluaron 4224 historias clínicas; se incluyeron 237 casos y 468 controles.

Los adolescentes con dolor tuvieron:

mayor edad (p < 0,0001; OR 2,3; IC 95%: 1,6-3,2); mayor cantidad de mujeres (p < 0,0001; OR 2,24; IC 95%: 1,61-3,12); 3) mayor desarrollo puberal (p= 0,0035; OR 2,16; IC 95%: 1,3-3,6); mayor abandono escolar (p < 0,0001; OR 13,4; IC 95%: 3,9-42,9); y mayor actividad laboral (p= 0,0001; OR 3,04; IC 95%: 1,7-5,3). Solamente la edad, sexo femenino y abandono escolar se asociaron independientemente a la consulta por dolor. No hubo diferencias significativas con obesidad y constitución familiar. Conclusión. Edad mayor, sexo femenino y abandono escolar fueron factores de riesgo independientes en la consulta por dolor en adolescentes. La pubertad y el trabajo se asociaron, pero no fueron factores de riesgo independientes.

Introduction. The most common painful syndromes (headache, abdominal pain and musculoskeletal pain) develop or worsen during adolescence and are a common reason for consultation. Objective. Evaluate the association of age, sex, obesity, pubertal development, schooling level, employment and family structure with consultation for pain in adolescents. Population and methods. Case-control study conducted between February 1st, 2014 and June 30th, 2015.

Inclusion criteria:

ages 10 to 20 years, both sexes, consultation for pain (cases), or a checkup and/or school physical (controls). χ² test and Student" s tests were used. Odds ratios (OR) were calculated. A binary logistic regression model was constructed to independently assess each pain-related variable. Results. A total of 4224 medical records were evaluated; 237 cases and 468 controls were included.

Adolescents with pain exhibited:

greater age (p < 0.0001; OR 2.3; 95% CI: 1.63.2); greater number of females (p < 0.0001; OR 2.24; 95% CI: 1.61-3.12); greater pubertal development (p < 0.0035; OR 2.16; 95% CI: 1.33.6); greater school dropout level (p < 0.0001; OR 13.4; 95% CI: 3.9-42.9); greater employment levels (p < 0.0001; OR 3.04; 95% CI: 1.7-5.3). Only age, female sex and school dropout were independently associated with consultation for pain. There were no significant differences with obesity and family structure. Conclusion. Older age, female sex and school dropout were independent risk factors in consultation for pain in adolescents. Puberty and employment were associated, but were not found to be independent risk factors.