Monash University, Monash Injury Research Institute, Clayton Campus, Victoria.
Pain Res Manag. 2012 Jan-Feb;17(1):35-44. doi: 10.1155/2012/935194.
Acute orthopedic trauma contributes substantially to the global burden of disease.
The present systematic review aimed to summarize the current knowledge concerning prognostic factors for the presence of persistent pain, pain severity and pain-related disability following acute orthopedic trauma involving a spectrum of pathologies to working-age adults.
The Ovid MEDLINE and EMBASE databases were searched for level II prognostic studies published between January 1996 and October 2010. Studies that were longitudinal and reported results with multivariate analyses appropriate for prognostic studies were included. Studies that addressed two specific injury types that have been the subject of previous reviews, namely, injuries to the spinal column and amputations, were excluded.
The searches yielded 992 studies; 10 studies met the inclusion criteria and were rated for methodological quality. Seventeen factors were considered in more than one cohort. There was strong evidence supporting the association of female sex, older age, high pain intensity, preinjury anxiety or depression, and fewer years of education with persistent pain outcomes. There was moderate evidence supporting the association between postinjury depression or anxiety with persistent pain, and that injury severity was not a risk factor for ongoing pain.
Many individuals experience persistent pain following acute trauma. Due to the lack of studies, the use of different constructs to measure the same factor and the methodological limitations associated with many of the studies, the present review was only able to reliably identify a limited set of factors that predicted persistent pain. Recommendations for the conduct of future methodologically rigorous studies of persistent pain are provided.
急性骨科创伤在全球疾病负担中占很大比例。
本系统评价旨在总结目前关于急性骨科创伤后持续性疼痛、疼痛严重程度和与疼痛相关的残疾的预后因素的知识，涉及到各种病理的工作年龄成年人。
在 Ovid MEDLINE 和 EMBASE 数据库中，搜索了 1996 年 1 月至 2010 年 10 月发表的 II 级预后研究。纳入了进行了纵向研究并报告了适合预后研究的多变量分析结果的研究。排除了涉及脊柱和截肢两种特定损伤类型的研究，这两种损伤类型以前已经有过综述。
搜索结果产生了 992 项研究；10 项研究符合纳入标准，并对其进行了方法学质量评价。有 17 个因素在多个队列中都有被考虑到。有强有力的证据支持女性、年龄较大、疼痛强度较高、受伤前焦虑或抑郁以及受教育程度较低与持续性疼痛结果之间的关系。有中度证据支持受伤后抑郁或焦虑与持续性疼痛之间的关系，而受伤严重程度不是持续疼痛的危险因素。
许多人在急性创伤后会经历持续性疼痛。由于缺乏研究、使用不同的结构来测量相同的因素以及许多研究中存在的方法学限制，本综述只能可靠地确定一组有限的预测持续性疼痛的因素。提供了关于进行未来具有严格方法学的持续性疼痛研究的建议。
