1.University of Twente, Enschede, 2. Medisch Spectrum Twente, Enschede 3. Admiraal de Ruyter Ziekenhuis, Goes, The Netherlands
EuSEM 2014
Incidence and predictors of chronic pain after
musculoskeletal injury
Pierik J.G.J1, IJzerman M.J. 1, Van Vugt A.B.2, Vollenbroek-Hutten M.M.R.1,
Background & aim
Methods
Design: prospective cohort study (one year follow-up)
Study population: 435 adult patients with isolated injury due to blunt trauma to the extremities of the musculoskeletal system
Setting: emergency department of Medisch Spectrum Twente 26 potential predictors
Results
incidence of chronic pain
43 out of 435 patients (9.9%) developed chronic pain (NRS≥4) 43.9% of the patients had some degree of pain
0 2 4 6 8 10 Me an pa in in te ns ity (N RS ) Non-chronic patients Chronic patients 0,0% 10,0% 20,0% 30,0% 40,0% 50,0% 60,0% NRS 0 NRS 1 NRS 2 NRS 3 NRS 4 NRS 5 NRS 6 NRS 7 NRS 8 Per cen ta ge of pa tie nts
Results
six predictors independently associated with chronic pain
Probability of developing chronic pain= 1/ (1+exp (-(-4.02 + 0.75*(age_≥40 years) + 0.64* (pain at discharge_severe) + 1.15*(pain catastrophizing_present) + 1.38*(chronic pain before injury_present) +0.62* (urgency level_urgent or
very urgent) + 0.54* (physical health_poor)).
0,1 1 10
OR adjusted
C-statistic:
0.81 (95% CI 0.74-0.88). Pain at discharge (severe)
Pain catatrophizing (present) chronic pain before injury (present) Age (>40 years) Urgency level (urgent or very urgent) Physical health (poor)
