Systematic review of the literature on pain in patients with polytrauma including traumatic brain injury

Steven Dobscha, Michael E. Clark, Benjamin Morasco, Michele Freeman, Rose Campbell, Mark Helfand

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Objective: To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design: Systematic review. Methods: We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results: One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions: Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated.

Original languageEnglish (US)
Pages (from-to)1200-1217
Number of pages18
JournalPain Medicine
Volume10
Issue number7
DOIs
StatePublished - Oct 2009

Fingerprint

Multiple Trauma
Pain
Headache
Pain Measurement
Qualitative Research
Wounds and Injuries
Sleep Initiation and Maintenance Disorders
Pain Management
Post-Traumatic Stress Disorders
Traumatic Brain Injury
MEDLINE
Observational Studies
Fatigue
Case-Control Studies
Depression
Therapeutics
Research

Keywords

  • Blast Injuries
  • Multiple Trauma
  • Pain
  • Traumatic Brain Injury
  • Veterans

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Medicine(all)

Cite this

Systematic review of the literature on pain in patients with polytrauma including traumatic brain injury. / Dobscha, Steven; Clark, Michael E.; Morasco, Benjamin; Freeman, Michele; Campbell, Rose; Helfand, Mark.

In: Pain Medicine, Vol. 10, No. 7, 10.2009, p. 1200-1217.

Research output: Contribution to journalArticle

@article{b827be0c572342518ab8eccbc6741ede,
title = "Systematic review of the literature on pain in patients with polytrauma including traumatic brain injury",
abstract = "Objective: To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design: Systematic review. Methods: We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results: One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions: Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated.",
keywords = "Blast Injuries, Multiple Trauma, Pain, Traumatic Brain Injury, Veterans",
author = "Steven Dobscha and Clark, {Michael E.} and Benjamin Morasco and Michele Freeman and Rose Campbell and Mark Helfand",
year = "2009",
month = "10",
doi = "10.1111/j.1526-4637.2009.00721.x",
language = "English (US)",
volume = "10",
pages = "1200--1217",
journal = "Pain Medicine",
issn = "1526-2375",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Systematic review of the literature on pain in patients with polytrauma including traumatic brain injury

AU - Dobscha, Steven

AU - Clark, Michael E.

AU - Morasco, Benjamin

AU - Freeman, Michele

AU - Campbell, Rose

AU - Helfand, Mark

PY - 2009/10

Y1 - 2009/10

N2 - Objective: To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design: Systematic review. Methods: We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results: One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions: Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated.

AB - Objective: To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design: Systematic review. Methods: We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results: One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions: Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated.

KW - Blast Injuries

KW - Multiple Trauma

KW - Pain

KW - Traumatic Brain Injury

KW - Veterans

UR - http://www.scopus.com/inward/record.url?scp=73949124496&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73949124496&partnerID=8YFLogxK

U2 - 10.1111/j.1526-4637.2009.00721.x

DO - 10.1111/j.1526-4637.2009.00721.x

M3 - Article

C2 - 19818031

AN - SCOPUS:73949124496

VL - 10

SP - 1200

EP - 1217

JO - Pain Medicine

JF - Pain Medicine

SN - 1526-2375

IS - 7

ER -