Research Article| Volume 218, ISSUE 5, P864-868, November 2019

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It still hurts! Persistent pain and use of pain medication one year after injury


      • Almost 1 in 2 trauma patients feel daily pain, one year after injury.
      • Approximately 1 in 4 trauma patients utilize pain medication at one year.
      • ISS was not correlated with chronic pain or long-term use of pain medication.
      • The power of predictors of pain and pain medication use was limited.



      Given the scarce literature data on chronic post-traumatic pain, we aim to identify early predictors of long-term pain and pain medication use after major trauma.


      Major trauma patients (Injury Severity Score ≥ 9) from three Level I Trauma Centers at 12 months after injury were interviewed for daily pain using the Trauma Quality of Life questionnaire. Multivariate logistic regression models identified patient- and injury-related independent predictors of pain and use of pain medication.


      Of 1238 patients, 612 patients (49%) felt daily pain and 300 patients (24%) used pain medication 1 year after injury. Of a total of 8 independent predictors for chronic pain and 9 independent predictors for daily pain medication, 4 were common (pre-injury alcohol use, pre-injury drug use, hospital stay ≥ 5 days, and education limited to high school). Combinations of independent predictors yielded weak predictability for both outcomes, ranging from 20% to 72%.


      One year after injury, approximately half of trauma patients report daily pain and one-fourth use daily pain medication. These outcomes are hard to predict.


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