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Screening tool may predict poor outcomes within days after musculoskeletal trauma injury


September 06, 2022

1 min read


The authors report no relevant financial disclosures.

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Result showed posttraumatic stress, pain distribution, pain intensity and number of fractures may successfully predict poor long-term pain outcomes within days of musculoskeletal trauma injury.

In a prospective cohort study, David W. Evans, PhD, and colleagues analyzed 124 patients (mean age, 48.9 years) with acute musculoskeletal trauma who were admitted to a major trauma center hospital from December 2018 to March 2020. The researchers measured poor pain outcomes — defined by a chronic pain grade II or higher — at 6 and 12 months. After analyzing pain mechanisms, quantitative sensory testing and psychosocial factors, the researchers determined which variables were most likely to be associated with a poor outcome. They then developed a clinical screening tool from 6-month results.

Increases in total posttraumatic stress symptoms, pain intensity average, number of fractures and pain extent were associated with worse outcomes at 6 months. Data were derived from Evans DW, et al. JAMA Network Open. 2022;doi:10.1001/jamanetworkopen.2022.28870.

At 6 months, 19 of 82 respondents (23.2%) reported a good outcome, whereas 27 of 44 respondents (61.4%) reported a good outcome at 12 months, according to the study. Evans and colleagues found increases in total posttraumatic stress symptoms (OR = 2.09), pain intensity average (OR = 2.87), number of fractures (OR = 2.79) and pain extent (OR = 4.67) were associated with worse outcomes at 6 months.

“Recovery of post-trauma pain can therefore be summarized as very slow and by no means certain for all, a message consistent with previous studies,” the researchers wrote.

“Our results confirm that a poor long-term outcome from musculoskeletal traumatic injuries can be estimated by measures recorded within days of injury,” they concluded.

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