title: Characteristics of Patients with Lower Extremity Trauma with Improved and Not Improved Pain During Hospitalization: A Pilot Study.
abstract: Up to 62% of patients report chronic pain at the injury site 6-12 months after blunt trauma, with pain from lower extremity fractures exceeding that from other sites. High pain intensity at time of injury is a risk factor for chronic pain, but it is not clear what patient characteristics influence the pain intensity level during the immediate hospitalization following injury. The purpose of this pilot study was to determine the feasibility of collecting pain scores from medical records to calculate pain trajectories and to determine whether it is possible to examine patient characteristics by classifying them into those whose pain improved and those whose pain did not improve. This descriptive study retrospectively reviewed medical records of 18 randomly chosen patients admitted to an academic trauma center. Patient characteristics and pain scores were collected form electronic and handwritten medical records. The pain trajectories calculated from routinely collected pain scores during the inpatient stay showed that for 44% of patients the pain improved during the hospitalization, for 39% the pain remained the same, and for 17% the pain worsened. The variables age, smoking, weight, abbreviated injury scores, length of hospital stay, mean pain score, and opioid equianalgesic dose differed based on pain trajectory. While patient characteristics differed based on pain trajectory, any significant effects seen from individual tests should be considered tentative, given the number of analyses conducted on this data set. However, feasibility and significance of conducting a larger study has been established.
authors.affiliation: Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD. Electronic address: mgrif001@umaryland.edu.
authors.forename: Mari A
authors.initials: MA
authors.lastname: Griffioen
authors.affiliation: Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD.
authors.forename: Meg
authors.initials: M
authors.lastname: Johantgen
authors.affiliation: Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Von Rueden
authors.affiliation: Department of Neural and Pain Sciences, University of Maryland School of Dentistry, 650 W. Baltimore Street, Baltimore, MD.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Greenspan
authors.affiliation: Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Dorsey
authors.affiliation: Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD. Electronic address: renn@son.umaryland.edu.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Renn
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid