Differential predictors of pain severity over 12 months following non-catastrophic injury sustained in a road traffic crash

There is paucity of prospective studies that have examined rates and prognostic indicators of pain severity after a road traffic crash injury. This cohort study involved 1,854 participants aged ≥17 years with a noncatastrophic injury. Primary analyses of pain severity involved 1604 individuals who reported any pain since the injury at baseline Of these, 1,188 and 972 participants were reexamined at the 6- and 12-month follow-up, respectively. The mean pain severity (primary study outcome) was assessed using a numeric rating scale (NRS), and a range of possible pain predictors were assessed. A mean pain NRS score of 4.9 was observed at baseline, and the mean NRS score was 2.1 at the 12-month follow-up. At the 6- and 12-month follow-up, 21% and 17.5% reported clinically significant pain (NRS score of ≥5), respectively. After multivariable adjustment, key predictors of pain severity ratings over the 12 months included the following, which were measured at baseline: age, sex, education, claim compensation, spine/back injury, being a bicyclist, physical well-being, pain-related catastrophizing, pain-related disability, and trauma-related and general psychological distress. Clinically significant pain was experienced by just >1 in 6 participants 12 months after injury. Several independent contributors to chronic pain identified in this study are modifiable, reinforcing their inclusion as targets in pain management programs. Perspective: This cohort study involving participants who sustained a noncatastrophic injury in a road traffic crash established the predictors of pain severity over 12 months. Study findings reiterate and reinforce the importance of being cognizant of a wide spectrum of biopsychosocial predictors both in the management and rehabilitation of injured persons.