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. 2021 May 4;6(1):e918.
doi: 10.1097/PR9.0000000000000918. eCollection 2021.

Prevalence of postamputation pain and its subtypes: a meta-analysis with meta-regression

Paul M Schwingler  1 , Rajat N Moman  2 , Christy Hunt  3 , Zachary Ashmore  1 , Sandra P Ogletree  1 , Mason E Uvodich  4 , M Hassan Murad  5 , W Michael Hooten  3
Affiliations

Prevalence of postamputation pain and its subtypes: a meta-analysis with meta-regression

Paul M Schwingler et al. Pain Rep. .

Abstract

Introduction: The inconsistent use of standardized approaches for classifying postamputation pain (PAP) has been a barrier to establishing its prevalence.

Objectives: The primary objective of this systematic review and meta-analysis is to determine the prevalence of nontraumatic lower-extremity PAP using an established taxonomy. The secondary objective is to determine the prevalence of PAP subtypes, including phantom limb pain and residual limb pain (RLP).

Methods: An a priori protocol was registered, and a database search was conducted by a reference librarian. Randomized trials and uncontrolled studies were eligible for inclusion. The risk of bias was assessed using a tool developed for uncontrolled studies. A total of 2679 studies were screened, and 13 studies met inclusion criteria (n = 1063).

Results: The sources of risk of bias included selection bias and, to a lesser extent, whether the outcome was adequately ascertained. Two studies reported the prevalence of PAP and the pooled prevalence was 61% (95% confidence interval [CI], 33%-86%) with high heterogeneity (I2 = 93%). Thirteen studies reported the prevalence of phantom limb pain and the pooled prevalence was 53% (95% CI, 40%-66%) with high heterogeneity (I2 = 93%). Eight studies reported the prevalence of RLP and the pooled prevalence was 32% (95% CI 24%-41%) with high heterogeneity (I2 = 76%). Clinical subtypes of RLP were not reported.

Conclusions: The prevalence of PAP is high in patients with nontraumatic lower-extremity amputations. Ongoing research that uses a taxonomy for PAP is needed to fully delineate the prevalence of PAP subtypes.

Keywords: Chronic pain; Phantom limb pain; Postamputation pain; Prevalence; Residual limb pain.

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Conflict of interest statement

The authors have no conflicts of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2.
Figure 2.
Prevalence of postamputation pain.
Figure 3.
Figure 3.
Prevalence of phantom limb pain.
Figure 4.
Figure 4.
Prevalence of residual limb pain.
See this image and copyright information in PMC

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