Predictors of Moderate or Severe Pain 6 Months After Orthopaedic Injury: A Prospective Cohort Study

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Abstract
Objective: To determine predictors of moderate or severe pain 6 months after orthopaedic injury. Design: Prospective cohort study. Setting: Two adult level 1 trauma centers in Victoria, Australia. Participants: A total of 1290 adults admitted with orthopaedic injuries and registered by the Victorian Orthopaedic Trauma Outcomes Registry. Main Outcome Measures: Participant self-reported pain and health status using an 11-point numerical rating scale and the 12-item Short-Form health survey, respectively. Results: The prevalence of moderate or severe pain was 48% [95% confidence interval (CI), 45-51] at discharge and 30% (95% CI, 28-33) at 6 months postinjury. Failure to complete high school [adjusted odds ratio (AOR) 1.5 (95% CI, 1.1-1.9)], self-reported preinjury pain-related disability [AOR 1.8 (95% CI, 1.3-2.5)], eligibility for compensation [AOR 2.1 (95% CI, 1.6-2.8)], and moderate or severe pain at discharge from the acute hospital [AOR 2.4 (95% CI, 1.8-3.1)] were found to be independent predictors of moderate or severe pain at 6 months postinjury. Conclusions: Moderate or severe pain is commonly reported 6 months after orthopaedic trauma. Pain intensity at discharge and the effects of a “no-fault” compensation system are potentially modifiable factors that might be addressed through intervention studies to reduce the burden of persistent pain after orthopaedic trauma.

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