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The Biopsychosocial Model to Identify Risk Factors for Chronic Postoperative Pain in Orthopedic Trauma Surgery Patients (TRAUMA PAIN)

1 juli 2026 bijgewerkt door: University Hospital, Montpellier
This study aims to assess multidimensional risk factors for chronic post-traumatic pain in orthopedic trauma surgery patients. The purpose is to better understand pain chronification mechanisms by quantifying the interaction between clinical, biological, therapeutic, and psychosocial factors during hospitalization, with the ultimate goal of developing a convergent model to predict patients at risk before hospital discharge.

Studie Overzicht

Toestand

Nog niet aan het werven

Interventie / Behandeling

Gedetailleerde beschrijving

According to the International Classification of Diseases 11th (ICD-11) classification, chronic post-traumatic pain is defined as pain persisting for more than 3 months following tissue injury. Given its physical, psychological, and social consequences, chronic pain represents a major source of disability, functional limitation, and impaired quality of life. Chronic pain frequently develops after accidental trauma, particularly in patients sustaining musculoskeletal injuries such as fractures.

Traumatic fractures requiring surgical treatment are among the most common causes of severe acute pain and may result in persistent pain despite fracture healing and satisfactory surgical outcomes. Chronic post-traumatic pain following orthopedic trauma surgery is associated with prolonged functional impairment, delayed return to work, psychological distress, and decreased quality of life.

Current evidence suggests that chronic post-traumatic pain results from a complex interaction between injury-related characteristics, biological vulnerability, therapeutic management, and psychosocial factors. However, these multidimensional determinants remain incompletely understood in orthopedic trauma populations.

The primary objective of this study is to identify early risk factors associated with chronic post-traumatic pain. In this study, patients undergo a comprehensive multidimensional evaluation throughout hospitalization. Fracture-related characteristics, including fracture location, injury severity, surgical management, analgesic strategies, and rehabilitation pathways, as well as therapeutic management, are systematically documented. Psychosocial factors and post-traumatic symptoms are assessed during hospitalization and at 3- and 6-month follow-up visits.

In addition to clinical and psychosocial assessments, biological samples are collected from hospital admission until discharge. This biological component focuses on brain-derived neurotrophic factor (BDNF). BDNF, initially described for its role in synaptic plasticity, has been increasingly implicated in central sensitization processes involved in pain chronification. By integrating clinical, biological, therapeutic, and psychosocial data, this study aims to characterize mechanisms associated with chronic post-traumatic pain and to develop a convergent predictive model to identify patients at high risk prior to hospital discharge.

Studietype

Observationeel

Inschrijving (Geschat)

600

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

Adult patients admitted for orthopedic trauma surgery following traumatic fracture

Beschrijving

Inclusion Criteria:

  • Adult patients aged 18 years or older
  • Surgical treatment for a traumatic fracture
  • Admission to an orthopedic trauma surgery department
  • Ability to participate in follow-up assessments
  • Informed consent

Exclusion Criteria:

  • Patient unable to exercise consent
  • Patients unable to complete the self reported assessment questionnaires

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
TRAUMA-PAIN SURGERY Cohort
This cohort includes adult patients undergoing orthopedic trauma surgery for traumatic fractures
  • biological collection of residual peripheral venous blood samples
  • use of samples from this collection for BDNF (Brain-Derived Neurotrophic Factor) analysis
  • collection of data from medical records
  • collection of psychosocial and patient-reported outcome data

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Chronic Post-traumatic Pain
Tijdsspanne: More than 3 months post-trauma

Presence of chronic post-traumatic pain, defined as a visual analog scale (VAS) score greater than 3 persisting more than 3 months post-trauma.

The Visual Analog Scale (VAS) scores range from 0 (no pain) to 10 (worst imaginable pain).

More than 3 months post-trauma

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Visueel Analoge Schaal (VAS) Pijnscore
Tijdsspanne: Van ziekenhuisopname tot 6 maanden na het trauma
Pijnintensiteit beoordeeld met een visueel analoge schaal (VAS). Scores variëren van 0 (geen pijn) tot 10 (ergst denkbare pijn).
Van ziekenhuisopname tot 6 maanden na het trauma
Injury Severity Score (ISS)
Tijdsspanne: Baseline (At hospital admission, day 0)
Severity of traumatic injuries assessed using the Injury Severity Score. Scores range from 1 (minor injury) to 75 (most severe injury).
Baseline (At hospital admission, day 0)
Pain Catastrophizing Profile
Tijdsspanne: Baseline (At hospital admission, day 0)
Pain catastrophizing assessed using the Pain Catastrophizing Scale (PCS). Scores range from 0 (no catastrophizing) to 52 (maximum catastrophizing).
Baseline (At hospital admission, day 0)
Trait Anxiety (STAI-Trait)
Tijdsspanne: Baseline (At hospital admission, day 0)

Trait anxiety assessed using the State-Trait Anxiety Inventory - Trait subscale (STAI-Trait).

Scores range from 20 (low trait anxiety) to 80 (high trait anxiety).

Baseline (At hospital admission, day 0)
Anxiety Intensity (Visual Analog Scale)
Tijdsspanne: From hospital admission through 6 months post-trauma
State anxiety intensity assessed using a Visual Analog Scale (VAS). Scores range from 0 (no anxiety) to 10 (worst imaginable anxiety).
From hospital admission through 6 months post-trauma
Neuropathic Pain Characteristics (DN4 Questionnaire)
Tijdsspanne: During hospitalization and at 3 and 6 months post-trauma
Neuropathic pain characteristics assessed using the DN4 questionnaire. Scores range from 0 (no neuropathic pain) to 10 (definite neuropathic pain).
During hospitalization and at 3 and 6 months post-trauma
Brief Pain Inventory (BPI)
Tijdsspanne: At 3 and 6 months post-trauma

Pain assessed with the Brief Pain Inventory (BPI), including pain severity and pain interference subscales.

Both subscale scores range from 0 (no pain/no interference) to 10 (worst pain/maximum interference).

At 3 and 6 months post-trauma
Post-Traumatic Stress Symptoms (PCL-5)
Tijdsspanne: At 3 and 6 months post-trauma
Post-traumatic stress symptoms assessed with the PCL-5 questionnaire. Scores range from 0 (no symptoms) to 80 (severe symptoms).
At 3 and 6 months post-trauma
Opioid Misuse (POMI)
Tijdsspanne: At 3 and 6 months post-trauma
Opioid misuse assessed with the POMI questionnaire. Scores range from 0 (no misuse) to 6 (high risk of misuse).
At 3 and 6 months post-trauma
Quality of Life (SF-12)
Tijdsspanne: At 3 and 6 months post-trauma

Quality of life assessed using the SF-12 questionnaire. Physical Component Summary (PCS) and Mental Component Summary (MCS) scores range from 0 to 100.

Higher scores indicate better quality of life.

At 3 and 6 months post-trauma
Anxiety and Depression (HADS)
Tijdsspanne: At 3 and 6 months post-trauma

Anxiety and depression assessed using the Hospital Anxiety and Depression Scale (HADS).

Each subscale ranges from 0 to 21. Total score ranges from 0 to 42.

At 3 and 6 months post-trauma
Serum BDNF Concentration
Tijdsspanne: From admission (before surgery ) until discharge (from day 1 to day 28)
Serum concentration of Brain-Derived Neurotrophic Factor measured during hospitalization.
From admission (before surgery ) until discharge (from day 1 to day 28)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 juli 2026

Primaire voltooiing (Geschat)

1 september 2028

Studie voltooiing (Geschat)

1 december 2028

Studieregistratiedata

Eerst ingediend

21 juni 2026

Eerst ingediend dat voldeed aan de QC-criteria

1 juli 2026

Eerst geplaatst (Werkelijk)

6 juli 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

6 juli 2026

Laatste update ingediend die voldeed aan QC-criteria

1 juli 2026

Laatst geverifieerd

1 juni 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • TRAUMA PAIN Surgery

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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