Five-year Pain Intensity and Treatment Trajectories of Post-9/11 Veterans With Mild Traumatic Brain Injury
| Autor: | Megan E. Amuan, Mary Jo Pugh, Kangwon Song, Carlos A. Jaramillo, Blessen C. Eapen, Donald D. McGeary, Cindy A. McGeary, Jennifer Sharpe Potter, Chen Pin Wang |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Longitudinal study Time Factors Traumatic brain injury Psychological intervention Poison control Pain Occupational safety and health Article Cohort Studies 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Injury prevention medicine Humans Pain Management Longitudinal Studies Iraq War 2003-2011 Brain Concussion Pain Measurement Veterans business.industry Human factors and ergonomics Middle Aged medicine.disease United States United States Department of Veterans Affairs Anesthesiology and Pain Medicine Neurology Cohort Physical therapy Female Neurology (clinical) September 11 Terrorist Attacks business 030217 neurology & neurosurgery |
| Zdroj: | J Pain |
| ISSN: | 1528-8447 |
| Popis: | Pain is a pervasive problem that affects nearly half of the U.S. Veterans deployed in support of the Global War on Terror (Post-9/11 Veterans) and over half of the Post-9/11 Veterans with diagnosed traumatic brain injury (TBI). The goal of the current study was to identify pain phenotypes based on distinct longitudinal patterns of pain scores in light of pain treatment among Post-9/11 Veterans over 5 years of care using latent growth mixture analysis stratified by TBI status. Five pain phenotypes emerged: 1) simple low impact stable pain, 2) complex low impact stable pain, 3) complex low impact worsening pain, 4) complex moderate impact worsening pain, and 5) complex high impact stable pain. Baseline pain scores and slopes were significantly higher in Veterans with mild TBI for some phenotypes. The mild TBI cohort was younger, had more men, more whites, less blacks, less education, more unmarried, more Marines and Army, more active duty in comparison to the no TBI cohort. Distinct trajectories in pain treatment were apparent among the pain intensity subgroups. PERSPECTIVE: The complexity of pain in patients with mTBI is categorically different than those with no TBI. Pain in patients with mTBI is heterogeneous with distinct phenotypes which may explain poor outcomes in this group. Identification of the individual differences may have a significant impact on the success of interventions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|