Pain after a motor vehicle crash: The role of socio‐demographics, crash characteristics and peri‐traumatic stress symptoms

Abstract

Background:The vast majority of individuals who come to the emergency department (ED) for care after a motor vehicle collision (MVC) are diagnosed with musculoskeletal strain only and are discharged to home. A significant subset of this population will still develop persistent pain and posttraumatic psychological sequelae may play an important role in pain persistence. Methods: We conducted a multisite longitudinal cohort study of adverse posttraumatic neuropsychiatric sequelae among patients seeking ED treatment in the aftermath of a traumatic life experience. We report on a sub-group of patients (n = 666) presenting after an MVC, the most common type of trauma and we examine associations of socio-demographic and MVC characteristics, and persistent pain 8 weeks after MVC. We also examine the degree to which these associations are related to peritraumatic psychological symptoms and 2-week acute stress reactions using an applied approach. Results: Eight-week prevalence of persistent moderate or severe pain was high (67.4%) and positively associated with patient sex (female), older age, low socioeconomic status (education and income) and pain severity in the ED. Peritraumatic stress symptoms (distress and dissociation) appear to exert some influence on both acute pain and the transition from acute to persistent pain. Discussion and Conclusions: The early aftermath of an MVC may be an important time period for intervening to prevent and reduce persistent pain. Substantial variation in mediating pathways across predictors also suggests potential diverse and complex underlying biological and psychological pathogenic processes are at work in the early weeks following trauma. Significance: The first several days after trauma may dictate recovery trajectories.Persistent pain, pain lasting beyond the expected time of recovery, is associated with pain early in the recovery period, but also mediated through other pathways. Future work is needed to understand the complex neurobiological processes in involved in the development of persistent and acute post-traumatic pain.

Understanding people’s experiences of extrication while being trapped in motor vehicles: a qualitative interview study

“…The peritraumatic window experienced by our participants and variable pain experience is consistent with the findings of others 37. Our participants benefited from analgesics which is consistent with the findings of effectiveness studies 38…”

“…36 The peritraumatic window experienced by our participants and variable pain experience is consistent with the findings of others. 37 Our participants benefited from analgesics which is consistent with the findings of effectiveness studies. 38 When our participants experienced fear, it tended not to be in relation to their injuries or the future impact of such in injuries, but fear of further injury-particularly a fear of fire.…”

Sex-disaggregated analysis of the injury patterns, outcome data and trapped status of major trauma patients injured in motor vehicle collisions: a prespecified analysis of the UK trauma registry (TARN)

“…Postcollision behaviour and patient experience differences between female and male patients may contribute to the increased rate of entrapment in women, who are more likely to experience multiregion and widespread pain following an MVC, which may prevent them leaving the vehicle without assistance. 43 TARN does not record whether a patient was physically trapped by vehicle deformation or medically trapped (eg, by pain), which prevents further analysis within this dataset.…”

Breaking up with my idol: A qualitative study of the psychological adaptation process of renouncing fanship

“…The second type includes pre-trauma correlates such as prior psychopathology, prior trauma exposure, familial psychiatric history, and neurobiological factors (Rosellini 10.3389/fpsyg.2022.1030470 Frontiers in Psychology 04 frontiersin.org et al, 2018). The third type concerns peri-trauma factors including the duration/severity of trauma exposure, core belief challenge, and subjective fear (Oaie et al, 2018;Meiser-Stedman et al, 2019;Beaudoin et al, 2021). The fourth type involves post-trauma factors including coping strategies, rumination, resilience, attribution style, access to needed resources, social support, specific cognitive patterns, gratitude, etc.…”