Prevalence of Pain in Patients 1 Year After Major Trauma | Trauma and Injury | JAMA Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Crombie  IKDavies  HTMacrae  WA Cut and thrust: antecedent surgery and trauma among patients attending a chronic pain clinic.  Pain 1998;76 (1-2) 167- 171PubMedGoogle Scholar
Mkandawire  NCBoot  DABraithwaite  IJPatterson  M Musculoskeletal recovery 5 years after severe injury: long-term problems are common.  Injury 2002;33 (2) 111- 115PubMedGoogle Scholar
Castillo  RCMacKenzie  EAWegner  STBosse  MJ Prevalence of chronic pain seven years following limb threatening lower extremity trauma.  Pain 2006;124 (3) 321- 329PubMed10.1016/j.pain.2006.04.020Google Scholar
Duckworth  MPIezzi  T Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims.  Clin J Pain 2005;21 (3) 251- 261PubMedGoogle Scholar
Bryant  RAMarosszeky  JECrooks  JBaguley  IJGurka  JA Interaction of posttraumatic stress disorder and chronic pain following traumatic brain injury.  J Head Trauma Rehabil 1999;14 (6) 588- 594PubMedGoogle Scholar
Von Korff  MCrane  PLane  M  et al.  Chronic spinal pain and physical-mental comorbidity in the United States: results from the national comorbidity survey replication.  Pain 2005;113 (3) 331- 339PubMedGoogle Scholar
Lin  EHKaton  WVon Korff  M  et al.  Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial.  JAMA 2003;290 (18) 2428- 2429PubMedGoogle Scholar
MacKenzie  EJRivara  FPJurkovich  G  et al.  A national evaluation of the effect of trauma center care on mortality.  N Engl J Med 2006;354 (4) 366- 378PubMedGoogle Scholar
Von Korff  MOrmel  JKeefe  FJDworkin  SF Grading the severity of chronic pain.  Pain 1992;50 (2) 133- 149PubMedGoogle Scholar
Charlson  MEPompei  PAles  KLMacKenzie  CR A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.  J Chronic Dis 1987;40 (5) 373- 383PubMedGoogle Scholar
Saunders  JBAasland  OFBabor  TFde la Fuente  JRGrant  M Development of the Alcohol Use Disorders Identification Test (AUDIT).  Addiction 1993;88 (6) 791- 804PubMedGoogle Scholar
Committee on Injury Scaling, The Abbreviated Injury Scale: 1998 Revision (AIS-98).  Des Plaines, IL Association for the Advancement of Automotive Medicine1998;
Baker  SPO'Neill  BHaddon  W  JrLong  WB The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care.  J Trauma 1974;14 (3) 187- 196PubMedGoogle Scholar
Osler  TBaker  SPLong  W A modification of the Injury Severity Score that both improves accuracy and simplifies scoring.  J Trauma 1997;43 (6) 922- 926PubMedGoogle Scholar
Urquhart  DMWilliamson  ODGabbe  BJ  et al.  Outcomes of patients with orthopaedic trauma admitted to level 1 trauma centres.  Aust N Z J Surg 2006;76 (7) 600- 60610.1111/j.1445-2197.2006.03785.xGoogle Scholar
Kehlet  HJensen  TSWoolf  CJ Persistent postsurgical pain: risk factors and prevention.  Lancet 2006;367 (9522) 1618- 1625PubMedGoogle Scholar
Plesh  OGansky  SACurtis  DAPogrel  MA The relationship between chronic facial pain and a history of trauma and surgery.  Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88 (1) 16- 21PubMedGoogle Scholar
Aasvang  EKehlet  H Chronic postoperative pain: the case of inguinal herniorrhaphy.  Br J Anaesth 2005;95 (1) 69- 76PubMedGoogle Scholar
Poobalan  ASBruce  JSmith  WCKing  PMKrukowski  ZHChambers  WA A review of chronic pain after inguinal herniorrhaphy.  Clin J Pain 2003;19 (1) 48- 54PubMedGoogle Scholar
Von Korff  MMiglioretti  DL A prognostic approach to defining chronic pain.  Pain 2005;117 (3) 304- 313PubMedGoogle Scholar
Elliott  AMSmith  BHHannaford  PCSmith  WCChambers  WA The course of chronic pain in the community: results of a 4-year follow-up study.  Pain 2002;99 (1-2) 299- 307PubMedGoogle Scholar
Arnow  BAHunkeler  EMBlasey  CM  et al.  Comorbid depression, chronic pain, and disability in primary care.  Psychosom Med 2006;68 (2) 262- 268PubMedGoogle Scholar
Von Korff  M Epidemiologic and survey methods: chronic pain assessment. Turk  DCMelzack  R Handbook of Pain Assessment. New York, NY Guilford Press2001;603- 618Google Scholar
Zelman  DCHoffman  DLSeifeldin  RDukes  EM Development of a metric for a day of manageable pain control: derivation of pain severity cut-points for low back pain and osteoarthritis.  Pain 2003;106 (1-2) 35- 42PubMedGoogle Scholar
Paul  SMZelman  DCSmith  MMiaskowski  C Categorizing the severity of can cer pain: further exploration of the establishment of cutpoints.  Pain 2005;113 (1-2) 37- 44PubMedGoogle Scholar
Portenoy  RKUgarte  CFuller  IHaas  G Population-based survey of pain in the United States: differences among white, African American, and Hispanic subjects.  J Pain 2004;5 (6) 317- 328PubMedGoogle Scholar
Mogil  JSWilson  SGChesler  EJ  et al.  The melanocortin-1 receptor gene mediates female-specific mechanisms of analgesia in mice and humans.  Proc Natl Acad Sci U S A 2003;100 (8) 4867- 4872PubMedGoogle Scholar
Salovey  PSeiber  WJSmith  AFTurk  DCJobe  JBWillis  GB Reporting chronic pain episodes on health surveys.  Vital Health Stat 6 1992; (6) 1- 78Google Scholar
Morrison  RSMagaziner  JMcLaughlin  MA  et al.  The impact of post-operative pain on outcomes following hip fracture.  Pain 2003;103 (3) 303- 311PubMedGoogle Scholar
Original Article
March 1, 2008

Prevalence of Pain in Patients 1 Year After Major Trauma

Author Affiliations

Author Affiliations: Departments of Pediatrics (Dr Rivara), Epidemiology (Dr Rivara), and Surgery (Drs Jurkovich and Nathens) and the Harborview Injury Prevention and Research Center (Drs Rivara, Jurkovich, Nathens and Wang), University of Washington, Seattle; and Departments of Health Policy and Management (Dr MacKenzie) and Biostatistics (Dr Scharfstein), The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Dr Nathens is now with the Department of Surgery, University of Toronto School of Medicine, Toronto, Ontario, Canada.

Arch Surg. 2008;143(3):282-287. doi:10.1001/archsurg.2007.61

Objectives  To describe the prevalence of pain in a large cohort of trauma patients 1 year after injury and to examine personal, injury, and treatment factors that predict the presence of chronic pain in these patients.

Setting  Sixty-nine hospitals in 14 states in the United States.

Patients  There were 3047 patients (10 371 weighted) aged 18 to 84 years who were admitted to the hospital because of acute trauma and survived to 12 months after injury.

Main Outcome Measure  Pain 12 months after injury measured with the Chronic Pain Grade Scale.

Results  At 12 months after injury, 62.7% of patients reported injury-related pain. Most patients had pain in more than 1 body region, and the mean (SD) severity of pain in the last month was 5.5 (4.8) on a 10-point scale. The reported presence of pain varied with age and was more common in women and those who had untreated depression before injury. Pain at 3 months was predictive of both the presence and higher severity of pain at 12 months. Lower pain severity was reported by patients with a college education and those with no previous functional limitations.

Conclusions  Most trauma patients have moderately severe pain from their injuries 1 year later. Earlier and more intensive interventions to treat pain in trauma patients may be needed.