The following is a summary of “Is the relationship between chronic pain and mortality causal? A propensity score analysis,” published in the July 2024 issue of Pain by Ryan et al.

Chronic pain is a widespread condition that significantly impacts various aspects of life.

Researchers conducted a retrospective study assessing the causal relationship between chronic pain and mortality.

They utilized data from 19,971 participants aged 51 and older from the wave of the U.S. Health and Retirement Study (1998). To explore the potential causal impact of chronic pain on mortality over a 20-year period, propensity scores were matched, and inverse probability weighting was applied in combination with Cox proportional hazards models. The HRs with 95% CIs were observed.

The result showed a significant association between chronic pain and mortality (HR: 1.32, 95% CI: 1.26-1.38). After adjustment of confounders using various propensity score methods for sociodemographic and health variables, the rise in mortality hazard was observed, which was linked to pain is modest (5%-9%), with findings also indicating no causal effect (95% CIs for HRs narrowly including 1.0). The reduction underscores the influence of confounders like modifiable risk factors in the pain-mortality link. When depressive symptoms were treated as a mediator rather than a confounder, the evidence for a modest causal effect of pain on mortality was stronger (e.g., HR: 1.08, 95% CI: 1.01-1.15).

Investigators concluded that further research was needed to analyze exposure confounder interactions and explore the cumulative causal impact of chronic pain across multiple time points on mortality.

Source: journals.lww.com/pain/fulltext/9900/is_the_relationship_between_chronic_pain_and.649.aspx