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Pain Research and Management
Volume 2018, Article ID 7203218, 8 pages
Research Article

Early Factors Associated with the Development of Chronic Pain in Trauma Patients

1Department of Emergency Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
2Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
3Research Centre, Hôpital du Sacré-Coeur (CIUSSS du Nord de-l’Île-de-Montréal), Montreal, QC, Canada
4Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, Canada
5Axe de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQS du CHU-Québec, Quebec, Canada
6Département de médecine familiale et de médecine d’urgence, Faculté de médecine, Université Laval, Quebec, Canada
7Department of Emergency Medicine, McGill University Health Centre, McGill University, Montreal, QC, Canada
8Faculties of Dental Medicine and Medicine, Université de Montréal, Montreal, QC, Canada
9Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l’Île-de-Montréal), Montreal, QC, Canada
10Centre de recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
11Département d'anesthésiologie, Faculté de médecine, Université de Montréal, Montreal, QC, Canada

Correspondence should be addressed to Raoul Daoust; ac.nortoediv@tsuoad.luoar

Received 24 July 2017; Revised 24 October 2017; Accepted 29 November 2017; Published 30 January 2018

Academic Editor: Jacob Ablin

Copyright © 2018 Raoul Daoust et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To identify factors, available at the time of trauma admission, associated with the development of chronic pain to allow testing of preventive approaches. Methods. In a retrospective observational cohort study, we included all patients ≥ 18 years old admitted for injury in 57 adult trauma centers in the province of Quebec (Canada) between 2004 and 2014. Chronic pain was defined as follows: treated in a chronic pain clinic, diagnosed with chronic pain, or received at least 2 prescriptions of chronic pain medications 3 to 12 months postinjury. Results. A total of 95,134 patients were retained for analysis. Mean age was 59.8 years (±21.7), and 52% were men. The causes of trauma were falls (63%) and motor vehicle accidents (22%). We identified 14,518 patients (15.3%; 95% CI: 15.1–15.5) who developed chronic pain. After controlling for confounding factors, the variables associated with chronic pain were spinal cord injury (OR = 3.9; 95% CI: 3.4–4.6), disc-vertebra trauma (OR = 1.6; 95% CI: 1.5–1.7), history of alcoholism (OR = 1.4; 95% CI: 1.2–1.7), history of anxiety (OR = 1.4; 95% CI: 1.2–1.5), history of depression (OR = 1.3; 95% CI: 1.1–1.4), and being female (OR = 1.3; 95% CI: 1.2–1.3). The area under the receiving operating characteristic curve derived from the model was 0.80. Conclusions. We identified risk factors present on hospital admission that can predict trauma patients who will develop chronic pain. These factors should be prospectively validated.