title: Acute to chronic pain transition in extremity trauma: A narrative review for future preventive interventions (part 2).
abstract: BACKGROUND
  The first part of this series of 2 articles revealed that chronic pain is an important issue post extremity trauma (ET) involving permanent biological transformations. Interventions aimed at preventing chronic pain in ET patients are therefore required.
  
  
  OBJECTIVE
  To conduct a comprehensive analysis of literature on risk and protective factors for chronic pain post-ET to guide the development of relevant preventive interventions.
  
  
  METHODS
  A narrative review of the literature was undertaken. Databases were searched to identify studies on chronic pain prognostic factors in ET patients.
  
  
  RESULTS
  Demographic, injury-related and psychological factors were shown to either contribute to or limit acute to chronic pain transition. High-intensity acute pain hasconsistently been identified as an important chronic pain risk factor. Other significant documented risk factors include: female gender, older age, less than college education, lower limb injury, symptoms of anxiety and depression and pain catastrophizing. Pain self-efficacy and pain acceptance have been shown to protect individuals against chronic pain.
  
  
  CONCLUSIONS
  This narrative review highlights factors placing ET patients at higher risk of chronic pain or protecting them against this problem. Determining how these factors could be addressed in preventive interventions is the next step before undertaking their development.
authors.affiliation: Ingram School of Nursing, McGill University, 3506 University Street, Montréal H3A 2A7, Canada; Departments of Nursing, Orthopedics and Trauma, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada. Electronic address: melanie.berube2@mail.mcgill.ca.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Bérubé
authors.affiliation: Centre de recherche du Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Saint-Antoine Building, 850 Saint-Denis Street, Montréal H2X 0A9, Canada.
authors.forename: Manon
authors.initials: M
authors.lastname: Choinière
authors.affiliation: Departments of Nursing, Orthopedics and Trauma, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Surgery Department, Faculty of Medicine, Université de Montréal, C. P. 6128, Succursale, Centre-ville, Montréal H3C 3J7, Canada.
authors.forename: Yves G
authors.initials: YG
authors.lastname: Laflamme
authors.affiliation: Ingram School of Nursing, McGill University, 3506 University Street, Montréal H3A 2A7, Canada; Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, 3755 Chemin, Côte-Ste-Catherine, Montréal H3T 1E2, Canada.
authors.forename: Céline
authors.initials: C
authors.lastname: Gélinas
mesh_terms: D059787:Acute Pain / Q000209:etiology* / Q000517:prevention & control; D000367:Age Factors; D001134:Arm Injuries / Q000150:complications*; D058443:Catastrophization / Q000209:etiology / Q000517:prevention & control; D059350:Chronic Pain / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000150:complications*; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D020377:Self Efficacy; D012737:Sex Factors
keywords: Acute pain; Acute to chronic pain transition; Chronic pain; Extremity trauma; Limb injury; Prognostic factors; Protective factors; Risk factors