ArticleAmerican journal of translational research2025
Risk factors and interaction effects in recurrent low back pain.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
objectivesTo identify risk factors for low back pain (LBP) recurrence and develop a clinically applicable predictive model, with emphasis on interactions between key factors.
methodsA retrospective cohort study was conducted, including 216 patients with newly-diagnosed LBP as the derivation cohort (January 2023-June 2024) and 46 as the external validation cohort (July-December 2024). Independent risk factors were screened through univariate, least absolute shrinkage and selection operator (Lasso), and multivariate logistic regression. Interaction effects were evaluated. A nomogram was constructed and validated.
resultsThe 1-month recurrence rate was 33.8%. Independent risk factors for recurrence included elevated white blood cell (WBC) count (OR=4.555, P<0.001), anxiety (OR=25.256, P<0.001), working >8 h/day (OR=8.748, P<0.001), and elevated interleukin-1β (IL-1β) (OR=3.356, P=0.008). Significant multiplicative interactions were observed between body mass index (BMI) and working hours, WBC and anxiety, and anxiety and working hours (all P<0.05). A positive additive interaction between WBC and anxiety was identified (RERI)=3.928). The nomogram demonstrated excellent discrimination (area under the receiver operating characteristic curve (AUC)=0.906 in the derivation cohort; 0.902 in the validation cohort), good calibration (Hosmer-Lemeshow P=0.06, 0.61), and optimal net benefit.
conclusionElevated WBC, IL-1β, anxiety, and prolonged working hours predict LBP recurrence, with notable interactions among these factors. The proposed nomogram aids personalized risk stratification and informs work-related and psychological interventions.
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