Skip to content Skip to navigation
University of Warwick
  • Study
  • |
  • Research
  • |
  • Business
  • |
  • Alumni
  • |
  • News
  • |
  • About

University of Warwick
Publications service & WRAP

Highlight your research

  • WRAP
    • Home
    • Search WRAP
    • Browse by Warwick Author
    • Browse WRAP by Year
    • Browse WRAP by Subject
    • Browse WRAP by Department
    • Browse WRAP by Funder
    • Browse Theses by Department
  • Publications Service
    • Home
    • Search Publications Service
    • Browse by Warwick Author
    • Browse Publications service by Year
    • Browse Publications service by Subject
    • Browse Publications service by Department
    • Browse Publications service by Funder
  • Help & Advice
University of Warwick

The Library

  • Login
  • Admin

Chronic pain and mortality : a systematic review

Tools
- Tools
+ Tools

Smith, Diane, Wilkie, Ross, Uthman, Olalekan A., Jordan, Joanne L. and McBeth, John (2014) Chronic pain and mortality : a systematic review. PLoS One, Volume 9 (Number 6). Article number e99048. doi:10.1371/journal.pone.0099048

[img]
Preview
PDF
WRAP_Uthman_journal.pone.0099048.pdf - Published Version - Requires a PDF viewer.
Available under License Creative Commons Attribution.

Download (1233Kb) | Preview
Official URL: http://dx.doi.org/10.1371/journal.pone.0099048

Request Changes to record.

Abstract

Background: Chronic pain is common, often widespread and has a substantial impact on health and quality of life. The relationship between chronic pain and mortality is unclear. This systematic review aimed to identify and evaluate evidence for a relationship between chronic pain and mortality.

Methods: A search of ten electronic databases including EMBASE and MEDLINE was conducted in March 2012, and updated until March 2014. Observational studies investigating the association between chronic or widespread pain (including fibromyalgia) and mortality were included. Risk of bias was assessed and a meta-analysis was undertaken to quantify heterogeneity and pool results. A narrative review was undertaken to explore similarities and differences between the included studies.

Results: Ten studies were included in the review. Three reported significant associations between chronic or widespread pain and mortality in unadjusted results. In adjusted analyses, four studies reported a significant association. The remaining studies reported no statistically significant association. A meta-analysis showed statistically significant heterogeneity of results from studies using comparable outcome measures (n = 7)(I2 = 78.8%) and a modest but non-significant pooled estimate (MRR1.14,95%CI 0.95–1.37) for the relationship between chronic pain and all-cause mortality. This association was stronger when analysis was restricted to studies of widespread pain (n = 5,I2 = 82.3%) MRR1.22(95%CI 0.93–1.60). The same pattern was observed with deaths from cancer and cardiovascular diseases. Heterogeneity is likely to be due to differences in study populations, follow-up time, pain phenotype, methods of analysis and use of confounding factors.

Conclusion: This review showed a mildly increased risk of death in people with chronic pain, particularly from cancer. However, the small number of studies and methodological differences prevented clear conclusions from being drawn. Consistently applied definitions of chronic pain and further investigation of the role of health, lifestyle, social and psychological factors in future studies will improve understanding of the relationship between chronic pain and mortality.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Chronic pain, Mortality
Journal or Publication Title: PLoS One
Publisher: Public Library of Science
ISSN: 1932-6203
Official Date: 5 June 2014
Dates:
DateEvent
5 June 2014Published
10 June 2014Accepted
15 November 2013Submitted
Volume: Volume 9
Number: Number 6
Number of Pages: 17
Article Number: Article number e99048
DOI: 10.1371/journal.pone.0099048
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Funder: Arthritis Research UK, University of Keele

Request changes or add full text files to a record

Repository staff actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics

twitter

Email us: wrap@warwick.ac.uk
Contact Details
About Us