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Systematic review of prognostic factors for work participation in patients with sciatica

机译：适用于坐骨神经痛患者的工作参与预后因素的系统综述

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摘要

Sciatica impacts on the ability to work and may lead to a reduced return to work. This study reviewed and summarised prognostic factors of work participation in patients who received conservative or surgical treatment for clinically diagnosed sciatica. We searched MEDLINE, CINAHL, EMBASE and PsycINFO until January 2018. Cohort studies, using a measure of work participation as outcome, were included. Two independent reviewers performed study inclusion and used the Quality In Prognosis Studies tool for risk of bias assessment and GRADE to rate the quality of the evidence. Based on seven studies describing six cohorts (n=1408 patients) that assessed 21 potential prognostic factors, favourable factors for return to work (follow-up ranging from 3 months to 10 years) included younger age, better general health, less low back pain or sciatica bothersomeness, better physical function, negative straight leg raise-test, physician expecting surgery to be beneficial, better pain coping, less depression and mental stress, less fear of movement and low physical work load. Study results could not be pooled. Using GRADE, the quality of the evidence ranged from moderate to very low, with downgrading mainly for a high risk of bias and imprecision. Several prognostic factors like pain, disability and psychological factors were identified and reviewed, and these could be targeted using additional interventions to optimise return to work. PROSPERO registration number: CRD42016042497.
机译：坐骨神经痛对工作能力的影响，可能导致工作减少到工作。本研究审查并概述了在临床诊断的鞘型接受保守或手术治疗的患者的工作患者的预后因素。在2018年1月，我们搜索了Medline，Cinahl，Embase和Psycinfo。包括使用衡量工作参与的衡量标准的队列研究。两个独立审稿人进行了研究包容，并使用预后研究工具的质量，以获得偏见评估和等级的风险，以评估证据的质量。基于七项研究，描述了评估了21个潜在预后因素的六个队列（N = 1408名患者），返回工作的有利因素（3个月至10年的随访时间）包括更年轻的年龄，更好的一般健康，腰痛较低或坐骨神经和坐骨头，更好的物理功能，负直腿抬起试验，医生预计手术有益，疼痛更好，抑郁症和精神压力，减少运动和低的物理工作负荷。无法汇集研究结果。使用等级，证据的质量范围从中度到非常低，下降主要是为了高偏见和不精确的风险。确定和审查了疼痛，残疾和心理因素等几种预后因素，可以使用额外的干预措施来优化返回工作。 Prospero注册号：CRD42016042497。

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