Predicting postherpetic neuralgia in elderly primary care patients with herpes zoster: prospective prognostic study.

摘要: Postherpetic neuralgia (PHN) is the most frequent complication of herpes zoster (HZ) and difficult to treat. Timely identification high-risk HZ-patients enables physicians focus on PHN prevention. To assess which simple measure factors are independent predictors PHN, whether psychosocial serological/virological parameters have additional predictive value, a prospective cohort study in primary care was conducted. We included 598 elderly (>50 years) consecutive patients with acute HZ (rash 30 0-100 scale) after three months. The final prediction model obtained from multivariable logistic regression (internally) validated using bootstrapping techniques, adjusted for optimism. Forty-six (7.7%) developed PHN. Independent were age (odds ratio [OR]=1.08 per year), pain severity (OR=1.02 unit), presence severe rash (OR=2.31), duration before consultation (OR=0.78 day): area under receiver-operating-characteristic curve [ROC area]=0.77 (95% CI: 0.71-0.82). Of five PCL scores, only factor V ('trust healthcare') an predictor (OR=1.01 though it increased ROC 0.01 0.78. Spielberger's anxiety scores serological virological variables no predictors. Thus, four can help timely identify at risk