Research Reports - Persistent pain in adolescents following traumatic brain injury

J Pain. 2013 Oct;14(10):1242-9

Tham SW, Palermo TM, Wang J, Jaffe KM, Temkin N, Durbin D, Rivara FP

Traumatic brain injury (TBI) is a leading cause of pediatric disability. Although
persistent pain has been recognized as a significant postinjury complication,
there is a paucity of data concerning the postinjury pain experience of youth.
This study aimed to examine the prevalence of persistent pain in adolescents
after TBI, identify risk factors for pain, and evaluate the impact of pain on
adolescent health-related quality of life. Participants included 144 adolescents
with mild to severe TBI who were followed over 36 months after injury. At 3-,
12-, 24-, and 36-month assessments, measures of pain intensity, depression,
posttraumatic stress disorder, and health-related quality of life were completed
by adolescents. Findings demonstrated that 24.3% of adolescents reported
persistent pain (defined as usual pain intensity ≥3/10) at all assessment points
after TBI. Female sex (odds ratio = 2.73, 95% confidence interval = 1.12-6.63)
and higher levels of depressive symptoms at 3 months after injury (odds
ratio = 1.26, 95% confidence interval = 1.12-1.43) were predictors of persistent
pain at 36 months. Furthermore, mixed linear models indicated that early pain
experience at 3 months following TBI was associated with a significantly poorer
long-term health-related quality of life.PERSPECTIVE: This is the first study to
examine the prevalence of persistent pain over long-term follow-up in adolescents
after TBI and its impact on health-related quality of life. These findings
indicate that adolescents with TBI may benefit from timely evaluation and
intervention to minimize the development and impact of pain.

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