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Cited by 277Musculoskeletal pain and rehabilitationPain Management and Opioid UseChronic Disease Management Strategies

Severe chronic pain is associated with increased 10 year mortality. A cohort record linkage study

Torrance, Nicola, Elliott, Alison M., Lee, Amanda J., Smith, Blair H.·2010·European Journal of Pain
DOI 10.1016/j.ejpain.2009.07.006
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Abstract

Previous research has clearly demonstrated a link between chronic pain and poor health, and has suggested a link with increased mortality, though the latter is less consistent. In 1996 a cohort of 6940 individuals was recruited, and information collected, about reported chronic pain status, general health and socio‐demographic details. Ten years later, a record linkage was conducted between these data and the routinely collected national dataset for death registration. Primary cause of death was classified according to ICD‐10 codes. Survival analysis was conducted to obtain unadjusted and multi‐adjusted hazard ratios (HR) for all‐cause, system‐specific and disease‐specific mortality by chronic pain status. A total of 5858 (84.4%) of individuals from the original cohort were linked, including 1557 (26.6%) who had died. Survival analysis found significant associations between any reported chronic pain and all‐cause mortality (HR 1.32, 99% CI, 1.14–1.54) and a number of specific causes. However, when we adjusted for socio‐demographic factors and reported long‐term limiting illness, the significant association was lost. Survival among those reporting severe chronic pain was significantly worse than among those reporting mild or no chronic pain. After adjustment for socio‐demographic factors and reported long‐term limiting illness, severe chronic pain remained significantly associated with all‐cause mortality (HR 1.49, 99% CI 1.21–1.84) and all circulatory system disease deaths (HR 1.68, 99% CI 1.20–2.35). The evident association between any chronic pain and increased mortality can apparently be explained by confounding caused by socio‐demographic factors. However, severe chronic pain is associated with increased risk of mortality, independent of socio‐demographic factors.

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Crossref · 10.1016/j.ejpain.2009.07.006

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  • Severe chronic pain is linked to increased all-cause mortality.

    “with other studies linking severe chronic pain to general increased all-cause mortality (Moore 2014a; Torrance 2010).”

    From Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews (2017) · cites this paper as Torrance 2010

  • Chronic pain is associated with significant increase in morbidity and mortality.

    “It is of great relevance to primary care that chronic pain is also associated with significant increase in morbidity and mortality [11, 12], with 20–50 % of chronic pain sufferers having co-morbid depression [9, 13, 14•].”

    From Identification and Management of Chronic Pain in Primary Care: a Review (2016) · cites this paper as [11]

  • Severe chronic pain is significantly associated with all-cause mortality and particularly death from cardiovascular disease.

    “Torrance et al. established that severe chronic pain was significantly associated with all-cause mortality and particularly death from cardiovascular disease [11].”

    From Identification and Management of Chronic Pain in Primary Care: a Review (2016) · cites this paper as [11]

  • In assessing patients with chronic pain, physicians should view chronic pain as a serious risk marker for premature mortality.

    “Such evidence suggests that in assessing patients with chronic pain, physicians should view chronic pain as a serious risk marker for premature mortality [11, 14•].”

    From Identification and Management of Chronic Pain in Primary Care: a Review (2016) · cites this paper as [11]

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Authors
Torrance, N., Elliott, A. M., Lee, A. J., & Smith, B. H.
Affiliations
University of Aberdeen (GB)
Corresponding author
Torrance, Nicola
ORCID
Venue
European Journal of Pain
Publisher
Wiley
Published
2010-04
Volume
14
Issue
4
Pages
380-386
ISSN
  • 1090-3801 (ISSN-L)
  • 1532-2149
DOI
10.1016/j.ejpain.2009.07.006
OpenAlex
W2045868248
Cited by
276
References
30
Citations by year
2026: 10 · 2025: 9 · 2024: 15 · 2023: 21 · 2022: 16 · 2021: 20 · 2020: 30 · 2019: 21 · 2018: 12 · 2017: 27 · 2016: 20 · 2015: 13 · 2014: 16 · 2013: 14 · 2012: 17
FWCI
7.67
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 648 d)
Locations
  • European Journal of Pain (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
chronic pain, mortality, all-cause mortality, pain intensity, death registration
MeSH terms
Adult, Aged, Cause of Death, Chronic Disease, Female, Humans, Male, Medical Record Linkage, Middle Aged, Pain, Drug Prescriptions, Surveys and Questionnaires, Socioeconomic Factors, Cohort Studies, Proportional Hazards Models, Survival Analysis

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