@article{ref1,
title="Clinical significance of pain at hospital discharge following traumatic orthopaedic injury: general health, depression, and PTSD outcomes at 1 year",
journal="Clinical journal of pain",
year="2015",
author="Archer, Kristin R. and Heins, Sara E. and Abraham, Christine M. and Obremskey, William T. and Wegener, Stephen T. and Castillo, Renan C.",
volume="32",
number="3",
pages="196-202",
abstract="OBJECTIVES: The purpose of this study was to determine whether pain at hospital discharge is associated with general health and depression and post-traumatic stress disorder (PTSD) at 1 year following traumatic orthopaedic injury. <br><br>METHODS: This study prospectively enrolled 213 patients, 19 to 86 years of age, admitted to an Academic Level 1 trauma center for surgical treatment of a traumatic lower-extremity or upper-extremity orthopaedic injury. Pain at hospital discharge was measured with the Brief Pain Inventory. At 1 year follow-up, physical and mental health was assessed with the SF-12 and depressive and PTSD symptoms with the 9-item Patient Health Questionnaire (PHQ-9) and PTSD Checklist-Civilian Version (PCL-C), respectively. Cut-of scores of 10 on the PHQ-9 and 44 on the PCL-C classified patients as having depression or PTSD. <br><br>RESULTS: 133 patients (62%) completed follow-up at 1 year. Responders and nonresponders did not differ significantly on baseline characteristics. Multivariable regression found that increased pain at discharge was significantly associated with depression (OR=3.3; P<0.001) and PTSD (OR=1.4; P=0.03) at 1 year, after controlling for age, education, injury severity score, and either depressive or PTSD symptoms at hospital discharge. Early postoperative pain was not a significant risk factor for long-term physical and mental health. <br><br>DISCUSSION: Findings highlight the importance of early screening for uncontrolled postoperative pain to identify patients at high risk for poor psychological outcomes and who could benefit from more aggressive pain management. <br><br>RESULTS suggest early interventions are needed to address pain severity in patients with orthopaedic trauma.<p /> <p>Language: en</p>",
language="en",
issn="0749-8047",
doi="10.1097/AJP.0000000000000246",
url="http://dx.doi.org/10.1097/AJP.0000000000000246"
}