Michelle C Accardi-Ravid1, Joshua R Dyer2, Sam R Sharar3, Shelley Wiechman4, Mark P Jensen4, Hunter G Hoffman5, David R Patterson4. 1. Department of Anesthesiology & Pain Medicine, Harborview Medical Center, University of Washington, 325 9th Avenue, Seattle, WA, 98104, USA. mca9@uw.edu. 2. Department of Family Medicine, Peace Health Medical Group, Vancouver, USA. 3. Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA. 4. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. 5. Department of Mechanical Engineering, University of Washington, Seattle, WA, USA.
Abstract
BACKGROUND: Nearly 2.8 million people are hospitalized in the USA annually for traumatic injuries, which include orthopedic and internal organ injuries. Early post-injury pain is predictive of poor outcomes, including inability to eventually return to work, and long-term psychological distress. The goal of the present study was to improve our scientific understanding of trauma-related pain by examining (1) the nature and frequency of inpatient trauma pain and (2) the associations between inpatient trauma pain, education, opioid analgesic equivalent use, pain catastrophizing, and sleep quality. METHOD: The study included 120 patients hospitalized at a major level I regional trauma center for the care of (1) closed long bone or calcaneus fractures and/or (2) an intraabdominal injury caused by blunt force trauma and requiring surgical repair (i.e., laparotomy). Medical records were reviewed to obtain demographic information and information about opioid use during hospitalization. In addition, participants were administered measures of average pain intensity, pain catastrophizing, and sleep quality. RESULTS: Education, opioid analgesic equivalents, catastrophizing, and poor sleep quality together accounted for 28% of the variance of average pain intensity over a 24-h period (p < .001), with each variable making a significant independent association. CONCLUSION: Two of the factors associated with pain intensity in the study sample-catastrophizing and sleep quality-are modifiable. It is therefore possible that interventions that target these variables in patients who are hospitalized for trauma could potentially result in better long-term outcomes, including a reduced risk for developing chronic pain. Research to evaluate this possibility is warranted.
BACKGROUND: Nearly 2.8 million people are hospitalized in the USA annually for traumatic injuries, which include orthopedic and internal organ injuries. Early post-injury pain is predictive of poor outcomes, including inability to eventually return to work, and long-term psychological distress. The goal of the present study was to improve our scientific understanding of trauma-related pain by examining (1) the nature and frequency of inpatient trauma pain and (2) the associations between inpatient trauma pain, education, opioid analgesic equivalent use, pain catastrophizing, and sleep quality. METHOD: The study included 120 patients hospitalized at a major level I regional trauma center for the care of (1) closed long bone or calcaneus fractures and/or (2) an intraabdominal injury caused by blunt force trauma and requiring surgical repair (i.e., laparotomy). Medical records were reviewed to obtain demographic information and information about opioid use during hospitalization. In addition, participants were administered measures of average pain intensity, pain catastrophizing, and sleep quality. RESULTS: Education, opioid analgesic equivalents, catastrophizing, and poor sleep quality together accounted for 28% of the variance of average pain intensity over a 24-h period (p < .001), with each variable making a significant independent association. CONCLUSION: Two of the factors associated with pain intensity in the study sample-catastrophizing and sleep quality-are modifiable. It is therefore possible that interventions that target these variables in patients who are hospitalized for trauma could potentially result in better long-term outcomes, including a reduced risk for developing chronic pain. Research to evaluate this possibility is warranted.
Authors: Julia A Glombiewski; Alice T Sawyer; Jana Gutermann; Katharina Koenig; Winfried Rief; Stefan G Hofmann Journal: Pain Date: 2010-08-19 Impact factor: 6.961
Authors: Michael T Smith; Brendan Klick; Sharon Kozachik; Robert E Edwards; Radha Holavanahalli; Shelley Wiechman; Patricia Blakeney; Dennis Lezotte; James A Fauerbach Journal: Pain Date: 2008-03-24 Impact factor: 6.961