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Pain Research and Treatment
Volume 2015, Article ID 676212, 7 pages
Research Article

The Verbal Rating Scale Is Reliable for Assessment of Postoperative Pain in Hip Fracture Patients

1Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, 5000 Odense, Denmark
2Institute of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
3Institute of Public Health, Department of Biostatistics, University of Southern Denmark, 5000 Odense, Denmark

Received 10 December 2014; Revised 5 May 2015; Accepted 5 May 2015

Academic Editor: Robert L. Barkin

Copyright © 2015 Rune Dueholm Bech 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.


Background. Hip fracture patients represent a challenge to pain rating due to the high prevalence of cognitive impairment. Methods. Patients prospectively rated pain on the VRS. Furthermore, patients described the changes in pain after raising their leg, with one of five descriptors. Agreement between paired measures on the VRS at rest and by passive straight leg raise with a one-minute interval between ratings at rest and three-minute interval for straight leg raise was expressed by kappa coefficients. Reliability of this assessment of pain using the VRS was compared to the validity of assessing possible change in pain from the selected descriptors. Cognitive status was quantified by the short Orientation-Memory-Concentration Test. Results. 110 patients were included. Paired scores with maximum disagreement of one scale point reached 97% at rest and 95% at straight leg raise. Linear weighted kappa coefficients ranged from 0.68 (95% CI = 0.59–0.77) at leg raise to 0.75 (95% CI = 0.65–0.85) at rest. Unweighted kappa coefficients of agreement in recalled pain compared to agreement of paired VRS scores ranged from 0.57 (95% CI = 0.49–0.65) to 0.36 (95% CI = 0.31–0.41). Interpretation. The VRS is reliable for assessment of pain after hip fracture. The validity of intermittent questioning about possible change in pain intensity is poor.