A systematic review of early prognostic factors for persisting pain following acute orthopedic trauma

Fiona J Clay, Wendy L Watson, Stuart V Newstead, Roderick J McClure, Fiona J Clay, Wendy L Watson, Stuart V Newstead, Roderick J McClure

Abstract

Background: Acute orthopedic trauma contributes substantially to the global burden of disease.

Objectives: The present systematic review aimed to summarize the current knowledge concerning prognostic factors for the presence of persistent pain, pain severity and pain-related disability following acute orthopedic trauma involving a spectrum of pathologies to working-age adults.

Methods: The Ovid MEDLINE and EMBASE databases were searched for level II prognostic studies published between January 1996 and October 2010. Studies that were longitudinal and reported results with multivariate analyses appropriate for prognostic studies were included. Studies that addressed two specific injury types that have been the subject of previous reviews, namely, injuries to the spinal column and amputations, were excluded.

Results: The searches yielded 992 studies; 10 studies met the inclusion criteria and were rated for methodological quality. Seventeen factors were considered in more than one cohort. There was strong evidence supporting the association of female sex, older age, high pain intensity, preinjury anxiety or depression, and fewer years of education with persistent pain outcomes. There was moderate evidence supporting the association between postinjury depression or anxiety with persistent pain, and that injury severity was not a risk factor for ongoing pain.

Conclusion: Many individuals experience persistent pain following acute trauma. Due to the lack of studies, the use of different constructs to measure the same factor and the methodological limitations associated with many of the studies, the present review was only able to reliably identify a limited set of factors that predicted persistent pain. Recommendations for the conduct of future methodologically rigorous studies of persistent pain are provided.

Figures

Figure 1)
Figure 1)
Flow diagram for retrieval of studies for the present systematic review

References

    1. Blyth FM, March LM, Brnabic AJ, Jorm LR, Williamson M, Cousins MJ. Chronic pain in Australia: A prevalence study. Pain. 2001;89:127–34.
    1. Harstall C, Ospina M. How Prevalent is Chronic Pain. Clinical updates. International Association for the Study of Pain. 2003;10:2. < > (accessed February 27, 2011).
    1. Tunks ER, Crook J, Weir R. Epidemiology of chronic pain with psychological comorbidity: Prevalence, risk, course, and prognosis. Can J Psychiatry. 2008;53:224–34.
    1. Access Economics The High Price of Pain: The Economic Impact of Persistent Pain in Australia. Sydney: MBF Foundation; 2007. pp. 9–11.
    1. Dunstan DA, Covic T. Compensable work disability management: A literature review of biopsychosocial perspectives. Aust Occup Ther J. 2006;53:67–77.
    1. Bradley C, Harrison J. Descriptive Epidemiology of Traumatic Fractures in Australia. Canberra: Australian Institute of Health and Welfare; 2004.
    1. Harris IA, Young JM, Rae H, Jalaludin BB, Solomon MJ. Factors associated with back pain after physical injury: A survey of consecutive major trauma patients. Spine. 2007;32:1561–5.
    1. Scholten-Peeters GG, Verhagen AP, Bekkering GE, et al. Prognostic factors of whiplash-associated disorders: A systematic review of prospective cohort studies. Pain. 2003;104:303–22.
    1. Carroll LJ, Hogg-Johnson S, van der Velde G, et al. Course and prognostic factors for neck pain in the general population: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33:S75–82.
    1. Ehde DM, Jensen MP, Engel JM, Turner JA, Hoffman AJ, Cardenas DD. Chronic pain secondary to disability: A review. Clin J Pain. 2003;19:3–17.
    1. Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA, American Society of Interventional Pain Physicians Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician. 2009;12:E35–70.
    1. Dobscha SK, Clark ME, Morasco BJ, Freeman M, Campbell R, Helfand M. Systematic review of the literature on pain in patients with polytrauma including traumatic brain injury. Pain Med. 2009;10:1200–17.
    1. Maas AI, Lingsma HF, IMPACT Study Group New approaches to increase statistical power in TBI trials: Insights from the IMPACT study. Acta Neurochir Suppl. 2008;101:119–24.
    1. Roozenbeek B, Maas AI, Lingsma HF, et al. Baseline characteristics and statistical power in randomized controlled trials: Selection, prognostic targeting, or covariate adjustment? Crit Care Med. 2009;37:2683–90.
    1. Haddon W., Jr Advances in the epidemiology of injuries as a basis for public policy. Public Health Rep. 1980;95:411–21.
    1. National Centre for Classification in Health . The International Statistical Classification of Disease and Related Health Problems-Australian Modification (ICD-10-AM), 6th edn – Tenth revision. Sydney: National Centre for Classification in Health;
    1. American Academy of Orthopaedic Surgeons Orthopaedics. 2010. < . (Accessed July 7, 2010).
    1. Rothman K. Epidemiology: An Introduction. New York: Oxford University Press; 2002. p. 71.
    1. IASP Subcommitee on Taxonomy Classification of chronic pain. Description of chronic pain syndromes and definition of pain terms. Pain Suppl. 1986;3:S1–226.
    1. Ehde DM, Czerniecki JM, Smith DG, Campbell KM, Edwards WT, Jensen MP. Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. Arch Phys Med Rehabil. 2000;81:1039–44.
    1. Vles WJ, Steyerberg EW, Essink-Bot ML, et al. Prevalence and determinants of disabilities and return to work after major trauma. J Trauma. 2005;58:126–35.
    1. Hayden JA, Cote P, Bombardier C. Evaluation of the quality of prognosis studies in systematic reviews. Ann Intern Med. 2006;144:427–37.
    1. Sackett DL, Richardon WS, Rosenberg W, Haynes RB. Evidence-Based Medicine. Edinburgh: Churchill Livingstone; 2000.
    1. Clay FJ, Newstead SV, McClure RJ. A systematic review of early prognostic factors for return to work following acute orthopaedic trauma. Injury. 2010;41:787–803.
    1. Andrew NE, Gabbe BJ, Wolfe R, Williamson OD, Richardson MD, Edwards ER. Twelve-month outcomes of serious orthopaedic sport and active recreation-related injuries admitted to Level 1 trauma centers in Melbourne, Australia. Clin J Sport Med. 2008;18:387–93.
    1. Williamson OD, Gabbe BJ, Cameron PA, Edwards ER, Richardson MR. Predictors of moderate or severe pain 6 months after orthopaedic injury: A prospective cohort study. J Orthop Trauma. 2009;23:139–44.
    1. Ulvik A, Kvale R, Wentzel-Larsen T, Flaatten H. Quality of life 2–7 years after major trauma. Acta Anaesthesiol Scand. 2008;52:195–201.
    1. Jenewein J, Moergeli H, Wittmann L, Buchi S, Kraemer B, Schynder U. Development of chronic pain following severe accidental injury. Results of a 3-year follow-up study. J Psychosom Res. 2009;66:119–26.
    1. Holtslag HR, van Beeck EF, Lindeman E, Leenen LP. Determinants of long-term functional consequences after major trauma. J Trauma. 2007;62:919–27.
    1. Rivara FP, Mackenzie EJ, Jurkovich GJ, Nathens AB, Wang J, Scharfstein DO. Prevalence of pain in patients 1 year after major trauma. Arch Surg. 2008;143:282–7. discussion 8.
    1. Holmes A, Williamson O, Hogg M, et al. Predictors of pain severity 3 months after serious injury. Pain Med. 2010;11:990–1000.
    1. Hours M, Bernard M, Charnay P, et al. Functional outcome after road-crash injury: Description of the ESPARR victims cohort and 6-month follow-up results. Accid Anal Prev. 2010;42:412–21.
    1. Hoffman JM, Pagulayan KF, Zawaideh N, Dikmen S, Temkin N, Bell KR. Understanding pain after traumatic brain injury: Impact on community participation. Am J Phys Med Rehabil. 2007;86:962–9.
    1. Castillo RC, MacKenzie EJ, Wegener ST, Bosse MJ, LEAP Study Group Prevalence of chronic pain seven years following limb threatening lower extremity trauma. Pain. 2006;124:321–9.
    1. Baker SP, O’Neill B, Haddon W, Jr, Long WB. The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 14:187–96. 197.
    1. Engel G. The need for a new medical model: A challenge for biomedicine. Fam Syst Med. 1992;6:523–7.
    1. Turk DC. A diathesis-stress model of chronic pain and disability following traumatic injury. Pain Res Manag. 2002;7:9–19.
    1. Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. 2002;27:E109–20.
    1. Turk DC, Rudy TE. Towards a comprehensive assessment of chronic pain patients. Behav Res Ther. 1987;25:237–49.
    1. Karoly P, Jensen MP. Multimethod Assessment of Chronic Pain. New York: Pergamon; 1987.
    1. Jensen MP, Karoly P. Measurement of cancer pain via patient self-reporting. In: Chapman CR, Foley K, editors. Current and Emerging Issues in Research on Cancer Pain. Philadelphia: Lippincott-Raven; 1993. < > (Accessed January 7, 2010).
    1. Eich E, Reeves JL, Jaeger B, Graff-Radford B. Memory for pain: Relation between past and present pain intensity. Pain. 1985;23:375–9.
    1. Linton SJ. Occupational psychological factors increase the risk for back pain: A systematic review. J Occup Rehabil. 2001;11:53–66.
    1. Côté P, van der Velde G, Cassidy JD, et al. The burden and determinants of neck pain in workers: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S60–74.
    1. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008–12.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅