Highlights
- •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.
Abstract
Background
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.
Methods
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.
Results
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%.
Conclusions
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.
Keywords
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References
- Muscoskeletal recovery 5 years after severe injury: long-term problems are common.Injury. 2002; 33: 111-115
- Prevalence of pain in patients 1 Year after major trauma.Arch Surg. 2008; 143: 282-287
- Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.2016 (HHS Publication NO. SMA 16-4984 NSDUH Series H-51)
- Vital Signs: Overdoses of Prescription Opioid Pain Relievers – United States, 1999-2008. vol. 60. Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Center for Disease Control and Prevention, 2011: 5
- J Trauma Acute Care Surg. 2017; 83: 97-104
- Outcome after major trauma: 12-month and 18-month follow-up results from the trauma recovery project.J Trauma. 1999; 46: 765-773
- Outcome from injury: general health, work status, and satisfaction 12 Months after trauma.J Trauma. 2000; 48: 841-850
- Routine follow up of major trauma patients from trauma registries: what are the outcomes?.J Trauma. 2006; 61: 1393-1399
- Long term outcomes after moderate to severe traumatic brain injury.Disabil Rehabil. 2004; 26: 253-261
- Long-term survival in spinal cord injury: a fifty year investigation.Spinal Cord. 1998; 36: 266-274
- Factors influencing outcome following limb-threatening lower limb trauma: lessons learned from the lower extremity assessment project (LEAP).JAAOS. 2006; 14: 205-210
- Factors associated with long-term outcomes after injury: results of the functional outcomes and recovery after trauma Emergencies (FORTE) multicenter cohort study.Ann Surg. 2018;
- A multicenter study of post-traumatic stress disorder after injury: mechanism matters more than injury severity.Surgeon. 2018; 164: 1246-1250
- Telephone vs face-to-face interviewing in a community psychiatric survey.Am J Public Health. 1993; 83: 896-898
- Comparing telephone and face-to-face qualitative interviewing: a research note.Sage J. 2004; 4: 107-118
Article info
Publication history
Published online: April 01, 2019
Accepted:
March 25,
2019
Received in revised form:
March 12,
2019
Received:
February 3,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
