A registry-based observational cohort study examining patterns of pain and mental health symptoms and their impact on work or other activities after injury.

Abstract

This study aimed to examine patterns of pain and mental health after injury, and the patient characteristics associated with reductions in those symptoms. Research Method/ Design: This registry-based observational cohort study included all people $16 years old hospitalized for unintentional injuries from 2007 to 2014 who were included in the Victorian State Trauma Registry or Victorian Orthopaedic Trauma Outcomes Registry, survived to 12-months postinjury and did not have severe brain injury or spinal cord injury (N = 31,073). Symptoms and related impacts were measured with pain Numerical Rating Scale, EuroQol Five Dimensions Three Level questionnaire (EQ-5D-3L), and 12-item Short Form Health Survey (SF-12) pain and mental health items at 6-, 12-, and 24-months postinjury. Symptom patterns over time, and their predictors, were examined using Latent Class and Transition Analyses and multinomial logistic regression. Results: Four classes were identified: (1) Low pain and mental health problems (49-54%); (2) mental health problems only (11-12%); (3) pain problems only (18-23%); and (4) pain and mental health problems (16-17%). Most people stayed within the same class over time, or transitioned to fewer problems. People who transitioned to lower problems had higher socioeconomic status (e.g., higher education level, higher neighborhood-level advantage, and employment), better preinjury health (e.g., no disability or substance use condition) and noncompensable injuries. Conclusion/Implications: Reduced pain and mental health symptoms and related impairments were primarily associated with nonmodifiable biological, social, or economic characteristics. People with persistent symptoms were often already living with social disadvantage preinjury, and may have benefited from