Association between quality of life before an acute pain event and the development of chronic pain-related disability

Many studies have demonstrated that chronic pain negatively impacts quality of life (QoL). However, it remains uncertain whether an individual’s QoL prior to an episode of acute pain is associated with an increased risk of chronic pain-related disability. Our objective was to determine if an individual’s QoL prior to an acute painful event is associated with significant chronic pain-related disability following an emergency visit for acute pain.

This was a planned sub-study on a prospective cohort with a 3 month follow-up. The primary outcome was defined as at least a moderate disability on the Pain Disability Index. QoL was assessed using the Short Form-12 Health Survey, which consists of 12 questions grouped into eight subscales, each ranging from 0 to 100. These subscales are divided into four physical factors and four mental factors, with lower scores representing worse quality of health. We used a multivariable logistic regression to assess the association between pre-event QoL and at least moderate chronic pain-related disability.

A total of 1493 patients were included (mean age: 52 years [SD ± 16]; female: 53%). After multivariable analysis, poorer physical factors (AOR = 1.53; 95% CI 1.22–1.93) and poorer mental factors (AOR = 1.22; 95% CI 1.02–1.46) were independently associated with at least moderate chronic pain-related disability.

Patients with poorer QoL prior to experiencing acute pain are more likely to develop significant chronic pain-related disability. This could help identify patients at higher risk, enabling the implementation of preventive strategies aimed at improving overall prognosis.