TitlePain Across Traumatic Injury Groups: A National Institute on Disability, Independent Living, and Rehabilitation Research Model Systems Study.
Publication TypeJournal Article
Year of Publication2020
AuthorsAmtmann D, Bamer AM, McMullen K, Gibran NS, Hoffman JM, Bombardier CH, Carrougher GJ
JournalJ Trauma Acute Care Surg
Date Published2020 Jun 24
ISSN2163-0763
Abstract

BACKGROUND: Pain is a common problem after traumatic injury. We describe pain intensity and interference at baseline and one-year post injury in burn, traumatic brain (TBI) and spinal cord injury (SCI) survivors and compare them to the general population (GP). We tested a custom PROMISĀ® pain interference short form developed for use in trauma populations.

METHODS: We administered a pain intensity numerical rating scale and custom PROMIS pain interference short forms at baseline and/or one-year post-injury from participants (>18 years) at three Model System projects (Burn, TBI and SCI). Scores were compared across injury groups, pain intensity levels, and to the GP. Reliability and floor and ceiling effects of the custom PROMIS pain measures were calculated.

RESULTS: Participants (Burn=161, TBI=232, SCI=134) responded to the pain intensity and/or pain interference measures at baseline (n=432), one-year (n=288), or both (n=193). At baseline, pain interference and intensity were both significantly higher in all three groups than in the GP (all p<0.01). At one-year average pain intensity in SCI and Burn (p<0.01) participants was higher than the GP, but only SCI participants reported higher pain interference (p<0.01) than the GP. Half of all participants reported clinically significant pain interference (55 or higher) at baseline and one third at one-year. Reliability of the custom pain interference measure was excellent (>0.9) between T-scores of 48 and 79.

CONCLUSIONS: The custom pain interference short forms functioned well and demonstrated the utility of the custom PROMIS pain interference short forms in traumatic injury. Results indicate that for many people with Burn, TBI and SCI, pain remains an ongoing concern long after the acute injury phase is over. This suggests a need to continue to assess pain months or years after injury to provide better pain management for those with traumatic injuries.

LEVEL OF EVIDENCE: Epidemiologic study Level IV.

DOI10.1097/TA.0000000000002849
Alternate JournalJ Trauma Acute Care Surg
PubMed ID32590556