title: Inability to self-report pain after a stroke: a population-based study.
abstract: The frequency of not being able to self-report pain after a stroke has not been previously assessed in a population-based sample. We studied the epidemiology of this problem using a cohort of patients hospitalized after a stroke in Olmsted County, Minnesota, from June 1, 2008, to June 1, 2012. Overall, 52 of 388 (13.4%) individuals were unable to provide a meaningful response to either a Faces Pain Scale or Numerical Rating Scale on admission. Inability to self-report pain was associated with measures of stroke severity (P<.0001), aphasia severity (P<.0001), and level of consciousness (P<.0001). Inability to self-report pain on admission was further associated with either subsequent death during the hospitalization (P<.0001) or an inability to provide self-report on dismissal (P<.0001). Our study further defines the epidemiology of the inability to self-report pain after a stroke as being less common than previously thought. Attempts to validate observational pain scales for poststroke patients should focus on those individuals with aphasia and/or depressed levels of consciousness.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA. smith.jonathan@mayo.edu
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Smith
authors.forename: Kari L
authors.initials: KL
authors.lastname: Bottemiller
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Flemming
authors.forename: F
authors.initials: F
authors.lastname: Michael Cutrer
authors.forename: Edythe A
authors.initials: EA
authors.lastname: Strand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018672:Community Health Planning; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D057566:Self Report; D020521:Stroke / Q000150:complications*