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Frederick P. Rivara, MD, MPH; Ellen J. MacKenzie, PhD; Gregory J. Jurkovich, MD; Avery B. Nathens, MD, PhD, MPH; Jin Wang, MS, PhD; Daniel O. Scharfstein, ScD

Arch Surg. 2008;143(3):282-287.

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.

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.

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