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

Am J Surg. 2019 Nov;218(5):864-868. doi: 10.1016/j.amjsurg.2019.03.022. Epub 2019 Apr 1.

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: Chronic pain; Pain medication; Patient outcomes; Trauma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use*
  • Chronic Pain / drug therapy*
  • Chronic Pain / epidemiology
  • Chronic Pain / etiology
  • Chronic Pain / psychology
  • Drug Utilization / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Registries
  • Risk Factors
  • Treatment Outcome
  • Wounds and Injuries / complications*

Substances

  • Analgesics