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Prevalence and determinants of pain in spinal cord injury during initial inpatient rehabilitation: data from the Dutch spinal cord injury database

  • Tim C. Crul
    Affiliations
    Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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  • Marcel W.M. Post
    Affiliations
    Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands

    University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
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  • Johanna M.A. Visser-Meilij
    Affiliations
    Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands

    Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Janneke M. Stolwijk-Swüste
    Correspondence
    Corresponding author: J. Stolwijk, Rembrandtkade 10, 3583 TM, Utrecht, the Netherlands, +31 30 256 1211
    Affiliations
    Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands

    Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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      Objective

      To describe the prevalence and characteristics of spinal cord injury (SCI) related pain during initial inpatient rehabilitation and to investigate relationships with demographic and lesion characteristics.

      Design

      Cohort during inpatient rehabilitation.

      Setting

      Eight specialized SCI rehabilitation centers in the Netherlands.

      Participants

      Patients with newly acquired SCI admitted for inpatient rehabilitation between November 2013 and August 2019.

      Interventions

      Not applicable.

      Main Outcome Measures

      Presence of pain at admission and discharge. Logistic regression analyses were used to study the prevalence of pain related to sex, age, etiology, completeness and level of injury.

      Results

      Data from 1432 patients were available. Of these patients 64.6% were male, mean age was 56.8 years, 59.9% had a non-traumatic SCI, 63.9% were classified as ASIA impairment scale (AIS) D and 56.5% were paraplegic. Prevalence of pain was 61.2% at admission (40.6% nociceptive pain (NocP), 30.2% neuropathic pain (NeuP) and 5.4% other pain) and 51.5% at discharge (26.0% NocP, 31.4% NeuP and 5.7% other pain). Having NocP at admission was associated with traumatic SCI. AIS B had a lower risk of NocP compared to AIS D at admission. Having NocP at discharge was associated with female sex and traumatic SCI. AIS C compared to AIS D had a lower risk of NocP at discharge. Having NeuP at admission was associated with female sex. Having NeuP at discharge was associated with female sex, age <65 vs >75 and tetraplegia.

      Conclusion

      SCI-related pain is highly prevalent during inpatient rehabilitation. Prevalence of NocP decreased during inpatient rehabilitation and prevalence of NeuP stayed the same. Different patient and lesion characteristics were related to the presence of SCI-related pain. Healthcare professionals should be aware of these differences in screening patients on presence and development of pain during inpatient rehabilitation.

      Key words

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