Patterns of diagnosis and referral in women consulting for chronic pelvic pain in UK primary care

作     者：Zondervan, KT Yudkin, PL Vessey, MP Dawes, MG Barlow, DH Kennedy, SH 

作者机构：Univ Oxford Inst Hlth Sci Dept Publ Hlth Div Publ Hlth & Primary Hlth Care Oxford OX3 7LF England John Radcliffe Hosp Nuffield Dept Obstet & Gynaecol Oxford OX3 9DU England 

出 版 物：《BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY》 (国际产、妇科学杂志)

年 卷 期：1999年第106卷第11期

页      面：1156-1161页

核心收录：

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：慢性病 发病率 骨盆痛/诊断 骨盆痛/流行病学 骨盆痛/病因学 转诊和会诊/统计学和数值数据 回顾性研究 妇女卫生保健服务/统计学和数值数据 青少年 成年人 女(雌)性 人类 中年人 

摘      要：Objectives To describe duration of symptoms and patterns of diagnosis and referral in women with chronic pelvic pain. Design Retrospective cohort analysis of the MediPlus UK Primary Care Database. Setting One hundred and thirty-six general practices in the UK. Study group A cohort of 5051 incident cases of chronic pelvic pain. Methods The cohort was followed up from the start of their symptoms in 1992 until the end of the chronic pelvic pain episode or the end of 1995. Main outcome measures Duration of symptoms, frequency of diagnoses and referral rates. Results A third of women had symptoms persisting for more than two years. Duration of symptoms increased significantly with age (P 0.001) from a median of 13.7 months in 13-20 year olds to 20.2 months in women over the age of 60. Irritable bowel syndrome and cystitis were the most common diagnoses at all ages. Twenty-eight percent of women never received a diagnosis during three to four years of follow up after first consultation, and 60% of women had no evidence of a specialist referral. Women aged 21-50 and women whose final diagnosis was endometriosis received the largest number of diagnoses and had the highest referral rates. Conclusions The numbers and types of diagnosis given to a woman with chronic pelvic pain and the likelihood of specialist referral depend on her age, as well as on the duration of symptoms. Women seen in secondary care for chronic pelvic pain are a highly selected group and are likely to represent only the tip of the iceberg.