Recalled pain scores are not reliable after acute trauma
Easton RM et al. – In the study patients did not accurately recall their pain levels 1–2days after acute trauma. The results suggest that retrospective pain ratings are not reliable in trauma patients.Methods
- Prospective, cohort study of trauma resuscitation patients transported by ambulance to a major trauma centre.
- Patients with haemodynamic instability (SBP<90, HR>120) or GCS<14 on arrival were excluded.
- Momentary pain scores were measured on an 11–point verbal numerical rating scale by paramedics during prehospital management.
- Patients were evaluated within 48h of injury on the recall of their initial pain, pain during transport, and lowest pain score achieved by prehospital analgesia.
- Spearman's rank correlation and Bland–Altman tests were used to compare ambulance and hospital data.
- 88 trauma resuscitation patients (mean age 44years±18SD, male 74%, mean ISS: 7±5SD) were enrolled over a 5 month study period.
- Comparison of immediate and recalled pain scores produced Spearman's correlation coefficients of 0.71 for initial pain, 0.56 for pain during transport, and 0.45 for minimum pain scores.