Elsevier

The Journal of Pain

Volume 20, Issue 6, June 2019, Pages 676-684
The Journal of Pain

Differential Predictors of Pain Severity Over 12 Months Following Noncatastrophic Injury Sustained in a Road Traffic Crash

https://doi.org/10.1016/j.jpain.2018.11.011Get rights and content
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Abstract

There is paucity of prospective studies that have examined rates and prognostic indicators of pain severity after a road traffic crash injury. This cohort study involved 1,854 participants aged ≥17 years with a noncatastrophic injury. Primary analyses of pain severity involved 1604 individuals who reported any pain since the injury at baseline Of these, 1,188 and 972 participants were reexamined at the 6- and 12-month follow-up, respectively. The mean pain severity (primary study outcome) was assessed using a numeric rating scale (NRS), and a range of possible pain predictors were assessed. A mean pain NRS score of 4.9 was observed at baseline, and the mean NRS score was 2.1 at the 12-month follow-up. At the 6- and 12-month follow-up, 21% and 17.5% reported clinically significant pain (NRS score of ≥5), respectively. After multivariable adjustment, key predictors of pain severity ratings over the 12 months included the following, which were measured at baseline: age, sex, education, claim compensation, spine/back injury, being a bicyclist, physical well-being, pain-related catastrophizing, pain-related disability, and trauma-related and general psychological distress. Clinically significant pain was experienced by just >1 in 6 participants 12 months after injury. Several independent contributors to chronic pain identified in this study are modifiable, reinforcing their inclusion as targets in pain management programs.

Perspective

This cohort study involving participants who sustained a noncatastrophic injury in a road traffic crash established the predictors of pain severity over 12 months. Study findings reiterate and reinforce the importance of being cognizant of a wide spectrum of biopsychosocial predictors both in the management and rehabilitation of injured persons.

Key words

Road traffic crash
noncatastrophic injury
pain
pain catastrophizing
numeric rating scale

Cited by (0)

Funded by the New South Wales State Insurance Regulatory Authority. The funder participates in the Steering Group for the study but has no direct involvement with the scientific aspects of the study. I.C.’s salary is supported by an Australian National Health and Medical Research Council Practitioner Fellowship.

The authors have no conflicts of interest to declare.