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 Car crashes are the second most common form of trauma among older
adults, the researchers write in Annals of Emergency Medicine.
Lead author Timothy Platts-Mills, of the University of North
Carolina at Chapel Hill, said his team’s long-term goal is to
prevent this type of trauma from developing into persistent pain for
older adults.
“The purpose of this study was to determine the frequency of
persistent pain and functional decline and identify patient
characteristics associated with these outcomes,” Platts-Mills said
in an email.
His team recruited 161 patients age 65 and older who went to the
emergency room after a car crash but didn’t end up being
hospitalized. Patients with fractures, major cuts, and brain or
spine injuries were not included in the analysis.
The participants were interviewed in person at the hospital. They
also completed follow-up assessments by mail or phone at six weeks,
six months, and one year after the accident.
Pain was rated on a scale from 1 to 10, both overall and in 15
specific parts of the body. People reporting a pain level of 4 or
higher after six months were considered to have persistent pain.
Participants also rated their ability to perform daily functions
such as walk, climb stairs, and carry groceries.
In the initial emergency room interview, 72 percent of patients
reported moderate to severe pain. After six months, 26 percent were
still having moderate to severe pain from the car crash.
People with persistent pain were more likely to have had pain in the
head, neck, jaw, lower back, or legs in the emergency room.
Compared to patients without pain, patients who did have chronic
pain reported poor self-rated health and less formal education. They
were also more likely to have symptoms of depression before the
crash and to expect their recovery to take more than 30 days.
Participants with persistent pain also experienced much more “pain
interference” with their physical functioning and daily living
activities and were more likely to have changed their living
situation to get extra help.
Roger Fillingim, a distinguished professor at the University of
Florida College of Dentistry, noted that chronic pain is very common
and affects 100 million people in the United States.
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Fillingim, who studies the problem, said in an email that chronic
pain is “arguably the most expensive and most prevalent health
problem in the United States,” and that this is particularly true
for older adults.
Persistent pain carries additional health and safety risks. Previous
studies have shown that it increases risk of falls and may be
associated with decreased cognitive performance in older people,
Fillingim noted.
Platts-Mills said one way to combat persistent pain is to tackle it
early. “More effective control of pain symptoms in the emergency
department and in the early recovery period may reduce persistent
pain,” he said.
For older people who have been in an accident, Platts-Mills
recommends staying physically active to reduce long-term pain and
decline in physical functioning.
Platts-Mills also noted that many of the study’s participants had
not been re-evaluated by a physician after a few weeks, and that
this may be part of the issue.
“If you or a family or friend is in a car crash, it is important to
be re-evaluated if pain symptoms persist,” he advised.
SOURCE: bit.ly/1SQKq4g Annals of Emergency Medicine, online June 16,
2015.
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