Acute Longitudinal Pain Trajectories in the Traumatically Injured

Abstract

The purpose of this study was to determine if in-hospital pain trajectories exist and if certain pain trajectories predict the development of pain in 101 participants at four months post-trauma. The growth mixture model analysis suggested the presence of 5 latent classes, with observed and predicted trajectories. It appears that patients in classes 1 (low initial pain) and 3 (high initial pain dropping fast and staying low) tend to have less pain at 4 months, while patients in Class 5 (high initial pain dropping fast, but rebounding) tend to have more pain at 4 months. This study did not provide definitive evidence that the trajectory of in-hospital pain predicts the development of chronic pain. Unfortunately, the latent slope did not predict pain scores at four months. However, it was found that probability of developing chronic pain measured by the numeric pain score (NPS 0-3=no chronic pain, NPS 4-10=chronic pain) with a discharge NPS of 0-2 is 0.06, 2-4 is 0.29, 4-6 is 0.35, 6-8 is 0.50 and 8-10 are 0.80. Pain must be controlled in the hospital to prevent the development of chronic pain out of the hospital. Clinicians can identify those at risk by reviewing their average pain scores on the day of discharge. Perspective: This manuscript addresses the issues of pain trajectories that have been previously published in the Journal of Pain. However, this study applied the previously published ideas to the longitudinal development of chronic pain. This is a novel attempt at determining pain trajectories and their relationship to the development of chronic pain.