• Constantine S Velmahos, Juan P Herrera-Escobar, Syeda S Al Rafai, Shelby Chun Fat, Haytham Kaafarani, Deepika Nehra, George Kasotakis, Ali Salim, and Adil H Haider.
• Department of Biology, Massachusetts Institute of Technology, Cambridge, MA USA; Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School Boston, MA USA. Electronic address: velmahos@mit.edu.
• Am. J. Surg. 2019 Nov 1; 218 (5): 864-868.

BackgroundGiven the scarce literature data on chronic post-traumatic pain, we aim to identify early predictors of long-term pain and pain medication use after major trauma.MethodsMajor trauma patients (Injury Severity Score ≥ 9) from three Level I Trauma Centers at 12 months after injury were interviewed for daily pain using the Trauma Quality of Life questionnaire. Multivariate logistic regression models identified patient- and injury-related independent predictors of pain and use of pain medication.ResultsOf 1238 patients, 612 patients (49%) felt daily pain and 300 patients (24%) used pain medication 1 year after injury. Of a total of 8 independent predictors for chronic pain and 9 independent predictors for daily pain medication, 4 were common (pre-injury alcohol use, pre-injury drug use, hospital stay ≥ 5 days, and education limited to high school). Combinations of independent predictors yielded weak predictability for both outcomes, ranging from 20% to 72%.ConclusionsOne year after injury, approximately half of trauma patients report daily pain and one-fourth use daily pain medication. These outcomes are hard to predict.Copyright © 2019 Elsevier Inc. All rights reserved.

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