A Study Of Risk Factors For Postherpetic Neuralgia

Objective: To analyze the risk of Post-herpetic neuralgia(PHN)development using a survey study with medical records reviews.Methods: A survey of 197 inpatients was involved with herpes zoster from The First Affiliated Hospital of Anhui Medical University between January 2017 and January2018.Univariate and multivariate statistical analysis were performed to identify potential risk factors for the development of PHN.Results: Of the 197 hospitalized patients with herpes zoster,76.6% were over 50 years old,and 44.7% were male,and 55.3% were female.Cranial nerve involvement accounted for 49.2%,lumbosacral nerve involvement,intercostal nerve involvement,brachial plexus involvement and cervical plexus involvement accounted for 26.9%,15.7% and 8.1%,respectively.56.9% of hospitalized patients also had chronic diseases,more than half of which were hypertension or diabetes.There was no significant difference in the length of hospital stay among patients of different age groups,but the length of hospital stay in PHN group was longer than that in non-phn group.Univariate analysis showed that age,body side of skin lesion distribution,secondary bacterial infections of skin lesions,chronic disease,fever,abnormal glomerular filtration rate,degree of pain during the acute phase may affect the prognosis of HZ patients.The final model of multivariate logistic regression analysis showed that 50 years of ageand older(OR 16.350;95% CI: 4.365 ~ 61.237;P < 0.001),body side of skin lesion distribution(OR 0.374;95% CI: 0.173 ~ 0.807;P = 0.012),secondary bacterial infections of skin lesions(OR 2.927;95% CI: 1.160 ~ 7.385;P = 0.023),and degree of pain during the acute phase(OR 4.769;95% CI: 2.396 ~ 9.492;P <0.001)could be considered as independent predictors for PHN.In the follow-up survey,15% of the hospitalized patients with HZ were still accompanied by post-herpetic pruritosis(PHI)after 3months after the occurrence of the rash,and the Spearman rank correlation test results indicated that PHI had no correlation with PHN(r=0.097,P=0.177 > 0.05).58.9% of PHN patients still had pain after 1 year,among which 90.7% were patients aged ?50years and 46.5% were males and 53.5% were females.Conclusions: The inpatients with HZ were mainly elderly people over 50 years old.Cranial nerve had the highest proportion of inpatients,followed by thoracic nerve and lumbosacral nerve,which were not risk factors for PHN.Age greater than 50 years old,secondary bacterial infection of skin lesions,and the level of pain intensity during the acute phase of HZ are independent risk factors for PHN development.There was no correlation between PHI and PHN.About 58.9% of PHN patients still complained of pain after 1 year,mostly mild pain,mainly in patients over 50 years old.