| 18F-055 |
Analysis of patterns of QSART for patients with CRPS diagnosed using the Proposed Research Criteria
1Department
of Anesthesiology and Pain Medicine, Seoul National University Bundang
Hospital, Seongnam, Republic of Korea
2Department of Anesthesiology and Pain Medicine,
Seoul National University Hospital College of Medicine, Seoul, Republic of
Korea
Background
Quantitative Sensory Axon Reflex Test (QSART) is an diagnositc method for an objective evaluation of sudomotor dysfunction in complex regional pain syndrome (CRPS), but its validity remains controversial. The aim of this study is to investigate the diagnostic value of QSART for CRPS on the Budapest research criteria.
Methods
From January 2013 to December 2015, we investigated the electronic medical records of 184 consecutive patients, who underwent QSART, with a suspected diagnosis of CRPS. The following patient details were available for analysis: age, sex, diagnosis, type of CRPS, injury sites, laterality, secondary gain, pain intensities at the initial outpatient visit, duration of CRPS symptoms prior to evaluation at our pain center, QSART results, QST results, Thermography results, medications, and the treatment modalities received.
Results
The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of QSART for the diagnosis of CRPS according to the Budapest research criteria were 67.14, 40.62, 0.83, and 0.22, respectively. The odds ratio (OR) of QSART for diagnosing CRPS according to the Budapest research criteria was 1.40 (95% CI, 0.62 er, the OR of QSART for diagnosing CRPS type II among CRPS patients was 3.80 (95% CI, 1.36 ) and statistically significant. Among various signs of CRPS, sweating were the only significant predictors of a positive QSART result. QSART, ANS test, and thermography were not related to the outcome of sympathetic nerve block.
Conclusion
In conclusion, the diagnostic value of QSART as a screening or a confirmatory test for CRPS according to the Budapest research criteria is low. The results of autonomic nerve tests including QSART were not related to the outcome of sympathetic nerve block.
Quantitative Sensory Axon Reflex Test (QSART) is an diagnositc method for an objective evaluation of sudomotor dysfunction in complex regional pain syndrome (CRPS), but its validity remains controversial. The aim of this study is to investigate the diagnostic value of QSART for CRPS on the Budapest research criteria.
Methods
From January 2013 to December 2015, we investigated the electronic medical records of 184 consecutive patients, who underwent QSART, with a suspected diagnosis of CRPS. The following patient details were available for analysis: age, sex, diagnosis, type of CRPS, injury sites, laterality, secondary gain, pain intensities at the initial outpatient visit, duration of CRPS symptoms prior to evaluation at our pain center, QSART results, QST results, Thermography results, medications, and the treatment modalities received.
Results
The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of QSART for the diagnosis of CRPS according to the Budapest research criteria were 67.14, 40.62, 0.83, and 0.22, respectively. The odds ratio (OR) of QSART for diagnosing CRPS according to the Budapest research criteria was 1.40 (95% CI, 0.62 er, the OR of QSART for diagnosing CRPS type II among CRPS patients was 3.80 (95% CI, 1.36 ) and statistically significant. Among various signs of CRPS, sweating were the only significant predictors of a positive QSART result. QSART, ANS test, and thermography were not related to the outcome of sympathetic nerve block.
Conclusion
In conclusion, the diagnostic value of QSART as a screening or a confirmatory test for CRPS according to the Budapest research criteria is low. The results of autonomic nerve tests including QSART were not related to the outcome of sympathetic nerve block.
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