It still hurts! Persistent pain and use of pain medication one year after injury

Constantine S. Velmahos, Juan P. Herrera-Escobar, Syeda S. Al Rafai, Shelby Chun Fat, Haytham Kaafarani, Deepika Nehra, George Kasotakis, Ali Salim, Adil H. Haider

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Background: Given the scarce literature data on chronic post-traumatic pain, we aim to identify early predictors of long-term pain and pain medication use after major trauma. Methods: Major trauma patients (Injury Severity Score ≥ 9) from three Level I Trauma Centers at 12 months after injury were interviewed for daily pain using the Trauma Quality of Life questionnaire. Multivariate logistic regression models identified patient- and injury-related independent predictors of pain and use of pain medication. Results: Of 1238 patients, 612 patients (49%) felt daily pain and 300 patients (24%) used pain medication 1 year after injury. Of a total of 8 independent predictors for chronic pain and 9 independent predictors for daily pain medication, 4 were common (pre-injury alcohol use, pre-injury drug use, hospital stay ≥ 5 days, and education limited to high school). Combinations of independent predictors yielded weak predictability for both outcomes, ranging from 20% to 72%. Conclusions: One year after injury, approximately half of trauma patients report daily pain and one-fourth use daily pain medication. These outcomes are hard to predict.

Original languageEnglish
Pages (from-to)864-868
Number of pages5
JournalAmerican Journal of Surgery
Issue number5
Publication statusPublished - Nov 2019
Externally publishedYes


  • Chronic pain
  • Pain medication
  • Patient outcomes
  • Trauma


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