title: Chronic widespread pain after motor vehicle collision typically occurs through immediate development and nonrecovery: results of an emergency department-based cohort study.
abstract: Motor vehicle collision (MVC) can trigger chronic widespread pain (CWP) development in vulnerable individuals. Whether such CWP typically develops through the evolution of pain from regional to widespread or through the early development of widespread pain with nonrecovery is currently unknown. We evaluated the trajectory of CWP development (American College of Rheumatology criteria) among 948 European-American individuals who presented to the emergency department (ED) for care in the early aftermath of MVC. Pain extent was assessed in the ED and 6 weeks, 6 months, and 1 year after MVC on 100%, 91%, 89%, and 91% of participants, respectively. Individuals who reported prior CWP at the time of ED evaluation (n = 53) were excluded. Trajectory modeling identified a 2-group solution as optimal, with the Bayes Factor value (138) indicating strong model selection. Linear solution plots supported a nonrecovery model. Although the number of body regions with pain in the non-CWP group steadily declined, the number of body regions with pain in the CWP trajectory group (192/895, 22%) remained relatively constant over time. These data support the hypothesis that individuals who develop CWP after MVC develop widespread pain in the early aftermath of MVC, which does not remit.
authors.affiliation: TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC, USA Anesthesiology, University of North Carolina, Chapel Hill, NC, USA Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA Emergency Medicine, Spectrum Health System, Grand Rapids, MI, USA Emergency Medicine, Baystate Medical Center, Springfield, MA, USA Emergency Medicine, North Shore University Hospital, Manhasset, NY, USA Emergency Medicine, Saint Joseph Mercy Health System, Ypsilanti, MI, USA Emergency Medicine, University of Florida, Jacksonville, FL, USA Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: JunMei
authors.initials: J
authors.lastname: Hu
authors.forename: Andrey V
authors.initials: AV
authors.lastname: Bortsov
authors.forename: Lauren
authors.initials: L
authors.lastname: Ballina
authors.forename: Danielle C
authors.initials: DC
authors.lastname: Orrey
authors.forename: Robert A
authors.initials: RA
authors.lastname: Swor
authors.forename: David
authors.initials: D
authors.lastname: Peak
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Jones
authors.forename: Niels
authors.initials: N
authors.lastname: Rathlev
authors.forename: David C
authors.initials: DC
authors.lastname: Lee
authors.forename: Robert
authors.initials: R
authors.lastname: Domeier
authors.forename: Phyllis
authors.initials: P
authors.lastname: Hendry
authors.forename: Blair A
authors.initials: BA
authors.lastname: Parry
authors.forename: Samuel A
authors.initials: SA
authors.lastname: McLean
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000150:complications* / Q000209:etiology*; D015331:Cohort Studies; D018450:Disease Progression; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology; D010147:Pain Measurement; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D055815:Young Adult