Thursday, April 8, 2010
Previous research has demonstrated a clearly negative influence of chronic pain on health. Now, a new study portrays a profound link between severe chronic pain and death; inflicting nearly a 70% greater mortality risk than even cardiovascular disease.
In 1996 a large cohort of 6,940 persons was recruited by researchers at the University of Aberdeen, UK, and information collected about chronic pain status, general health, and sociodemographic details [Torrance, et al. 2010]. Followup 10 years later linked these data with routinely collected national data for death registration. A total of 5,858 (84%) individuals from the original cohort were linked, including 1,557 (27%) who had died. The researchers found a significant association between chronic pain and all-cause mortality. Particularly troublesome was severe chronic pain — survival among persons with this condition was significantly worse than among those reporting mild or no chronic pain. Even after adjusting for various confounding sociodemographic factors and effects of long-term illness, patients with severe chronic pain had a 49% greater risk of death compared with all-cause mortality and a 68% greater risk of death compared with all cardiovascular-disease-related deaths.
COMMENT: The negative impact of severe chronic pain on survival discovered by this research is dramatic and concerning; especially when considering the recent brouhaha about purportedly high risks associated with analgesic agents, particularly opioids. In an objective risk-benefit analysis, it would appear from this study that the increased mortality risks associated with untreated or inadequately treated chronic pain could pose a greater threat than any hazards potentially associated with pain-relieving medication therapies. In brief — and this is admittedly a strong way of putting it — any restrictions on access to effective therapies for severe chronic pain might be tantamount to fostering premature death in the afflicted patients. *As always, reader comments are welcomed.*
REFERENCE: Torrance N, Elliott AM, Lee AJ, Smith BH. Severe chronic pain is associated with increased 10 year mortality. A cohort record linkage study. Eur J Pain. 2010(Apr);14(4):380-386 [abstract here].