Anger at emergency department discharge increases chronic pain risk at four months

Abstract

Objective: To determine the impact of pain, stress, and negative emotions like anger, sadness, fear and regret in the persistence or development of chronic pain four months after admission to the emergency department (ED).

Methods: Data from 641 ED patients in the SOFTER IV clinical trial were analyzed. Pain, stress, and negative emotions were assessed at discharge, then dichotomized as non-severe or severe. Patients with chronic pain history were included in the analysis. Chronic pain at four months was evaluated using a binary yes/no question, and its predictors were identified using multivariable logistic regression with variable selection based on statistical significance.

Results: At four months post-ED admission, 35.1 % of patients reported chronic pain. As expected, a prior history of chronic pain was a strong predictor. Among patients with no history of chronic pain, those who reported severe anger at discharge were at nearly three times the risk of developing chronic pain (OR = 2.8, 95 % CI: 1.4-5.6). In addition, patients admitted for traumatic injuries and female patients also showed elevated risk, with odds ratios of 1.7 (95 % CI: 1.2-2.4) and 1.4 (95 % CI: 1.0-2.0), respectively.

Conclusion: Anger may affect the development or persistence of chronic pain after an emergency department admission.

Keywords: Anger; Chronic pain; Emergency department; Negative emotion.