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Examination of Pain Comorbid Diagnoses in the Inpatient Rehabilitation Population Across All Impairment Groups
Zachary A Curry1, Michael N Andrew, Michael C Chiang
1From the Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (ZAC, MNA, MCC, RG, RZ, JCS); Rehabilitation Outcomes Center at Spaulding, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (ZAC, MNA, MCC, RG, RZ, JCS); Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts (ZAC, MNA, MCC, RZ, JCS); Harvard Medical School, Boston, Massachusetts (ZAC, MNA, MCC, RZ, CMR, JCS); Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (CMR); Department of Surgery, Shriners Children's, Boston, Massachusetts (CMR); Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut (BCC); and Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut (BCC).
Objective:
Pain is common in inpatient rehabilitation patients; however, the prevalence of pain diagnoses in this population is not well-defined. This study examines comorbid pain diagnoses in inpatient rehabilitation patients across impairment groups.
Design:
Adult inpatient rehabilitation patients discharged from January 2016 through December 2019 were identified in the Uniform Data System for Medical Rehabilitation database using a literature-established framework containing International Classification of Diseases, Tenth Revision, Clinical (ICD-10-CM) pain diagnoses. Demographic data, clinical data, and pain diagnoses were compared across the 17 rehabilitation impairment groups.
Results:
Of 1,925,002 patients identified, 1,347,239 (70.0%) had at least one International Classification of Diseases, Tenth Revision (ICD-10) pain diagnosis. Over half of all patients in each impairment group had at least one pain diagnosis. The most common pain diagnoses were limb/extremity and joint pain, with variation between impairment groups. Female sex and being in the arthritis, major multiple trauma, and pain syndrome impairment groups were associated with a greater odds of a pain diagnosis.
Conclusions:
Over half of all patients in each rehabilitation impairment group have a pain diagnosis, which varies between impairment groups. Because of the high prevalence of pain diagnoses, a new focus on pain management in inpatient rehabilitation patients is needed. Rehabilitation outcomes may also be affected by pain.
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