Baseline pain intensity is a predictor of chronic pain in individuals with distal radius fracture

Study design: Secondary analysis of cohort study.

Objective: This study examined whether baseline pain intensity is a predictor of chronic pain and wrist/hand functions at 1 year following distal radius fracture (DRF). The study also examined the cutoff level for baseline pain intensity that best predicted chronic pain.

Background: Many individuals experience wrist/hand pain and functional impairments for as long as 1 year after DRF. Early identification of individuals at risk of these adverse outcomes can facilitate the delivery of required interventions to mitigate the risk.

Methods: Data for the Patient-Rated Wrist Evaluation (PRWE) pain and function subscales at baseline and 1 year after DRF, age, sex, injury to the dominant side, presence of comorbidity, education level, mechanism of fracture, smoking status, fall history, and energy of fracture were extracted from an existing data set. Multivariate regression analysis examined the utility of baseline pain intensity and the above variables in predicting pain and functional status at 1 year in individuals with DRF. Receiver operating characteristic curves examined the sensitivity/specificity of baseline pain intensity in predicting chronic pain and functional impairment.

Results: Required data were available for 386 individuals. Baseline pain intensity was found to be a strong predictor of chronic pain, explaining 22% of the variance. A baseline score of 35 out of 50 on the pain subscale of the PRWE had the best sensitivity (85%) and specificity (79%) cutoff values for predicting chronic pain at 1 year after DRF.

Conclusion: Rehabilitation practitioners may be able to use a score of greater than 35/50 on the PRWE pain subscale to screen individuals at risk of chronic pain following DRF.

Level of evidence: Prognosis, level 4.