CO111
Etude prospective de suivi de cas précoces de syndrome douloureux régional complexe (CRPS) : évolution du CSS ( CRPS Severity Score)
Soisic
Lecroc
(Sion, Suisse),
Philippe
Vuistiner
(sion, Suisse),
Bertrand
Léger
(sion, Suisse),
Konzelmann
Michel
(Sion, Suisse),
François
Luthi
(Sion, Suisse)
Objective :
The Complex Regional Pain Syndrome (CRPS) Severity Score (CSS) was proposed to allow a more precise follow-up of patients than the Budapest criteria alone. The objective of this study was to measure the evolution of the CSS of early CRPS patients with a follow-up of at least 1 year.
Material / Patients and Methods :
Prospective study including CRPS patients (<6 months). Use of the Budapest criteria, CSS (sum of 8 symptoms and 8 signs from the Budapest criteria), DN4, and Brief Pain Inventory.
Results :
69 patients were included, 39 with a 1-year follow-up. The mean time from initial trauma to inclusion was 116 days, and 87 days from symptoms suggestive of CRPS to inclusion.
At inclusion, mean CSS was 11.3 (±2.0) (range 0-16), pain severity 4.7 (±2.1), DN4 score: 4.3 (±2.7).
At 3 months, mean CSS was 8.3 (± 3.3).
At 12 months, mean CSS was 5.1 (±3.3), with 67% of patients showing a decrease of at least 4.9, considered as the smallest clinically important difference. DN4 was 2.5 (±2.2). Reduction in CSS was associated with reduction in DN4 (r=0.49). Higher CSS score at T0 was related to higher CSS reduction at T12 (r=0.41).
At inclusion, mean CSS was 11.3 (±2.0) (range 0-16), pain severity 4.7 (±2.1), DN4 score: 4.3 (±2.7).
At 3 months, mean CSS was 8.3 (± 3.3).
At 12 months, mean CSS was 5.1 (±3.3), with 67% of patients showing a decrease of at least 4.9, considered as the smallest clinically important difference. DN4 was 2.5 (±2.2). Reduction in CSS was associated with reduction in DN4 (r=0.49). Higher CSS score at T0 was related to higher CSS reduction at T12 (r=0.41).
Discussion - Conclusion :
This study confirms the importance of the CSS for the follow-up of CRPS patients. Our results are comparable to those of Harden from the original study on new CRPS regarding the reduction of the CSS score at 3 months. This study also shows a decrease of the CSS score beyond 3 months resulting in an increase of patients with clinically significant improvement.
Keywords :
Complex Regional Pain Syndrome (CRPS), CRPS Severity Score (CSS)