Constantine S Velmahos1, Juan P Herrera-Escobar2, Syeda S Al Rafai2, Shelby Chun Fat2, Haytham Kaafarani3, Deepika Nehra2, George Kasotakis4, Ali Salim2, Adil H Haider2. 1. Department of Biology, Massachusetts Institute of Technology, Cambridge, MA USA; Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School Boston, MA USA. Electronic address: velmahos@mit.edu. 2. Department of Surgery, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA. 3. Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School Boston, MA USA. 4. Department of Surgery, Division of Trauma, Acute Care Surgery & Surgical Critical Care, Boston University School of Medicine, Boston, MA USA.
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.
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 traumapatients (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 traumapatients report daily pain and one-fourth use daily pain medication. These outcomes are hard to predict.
Authors: Juan P Herrera-Escobar; Samia Y Osman; Sophiya Das; Alexander Toppo; Claudia P Orlas; Manuel Castillo-Angeles; Angel Rosario; Mahin B Janjua; Muhammad Abdullah Arain; Emma Reidy; Molly P Jarman; Deepika Nehra; Michelle A Price; Eileen M Bulger; Adil H Haider Journal: J Trauma Acute Care Surg Date: 2021-05-01 Impact factor: 3.697
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