Journal Article

The prevalence and risk factors for phantom limb pain in people with amputations: A systematic review and meta-analysis

Madden, Victoria J., Bedwell, Gillian J., Parker, Romy, Limakatso, Katleho

2020

Overview

Phantom limb pain (PLP)-pain felt in the amputated limb-is often accompanied by significant suffering. Estimates of the burden of PLP have provided conflicting data. To obtain a robust estimate of the burden of PLP, we gathered and critically appraised the literature on the prevalence and risk factors associated with PLP in people with limb amputations. Articles published between 1980 and July 2019 were identified through a systematic search of the following electronic databases: MEDLINE/PubMed, PsycINFO, PsycArticles, Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Health Source: Nursing/Academic Edition, SCOPUS, Web of Science and Academic Search Premier. Grey literature was searched on databases for preprints. Two reviewers independently conducted the screening of articles, data extraction and risk of bias assessment. The meta-analyses were conducted using the random effects model. A statistically significant level for the analyses was set at p<0.05. The pooling of all studies demonstrated a prevalence estimate of 64% [95% CI: 60.01-68.05] with high heterogeneity [I2 = 95.95% (95% CI: 95.10-96.60)]. The prevalence of PLP was significantly lower in developing countries compared to developed countries [53.98% vs 66.55%; p = 0.03]. Persistent pre-operative pain, proximal site of amputation, stump pain, lower limb amputation and phantom sensations were identified as risk factors for PLP. This systematic review and meta-analysis estimates that six of every 10 people with an amputation report PLP-a high and important prevalence of PLP. Healthcare professionals ought to be aware of the high rates of PLP and implement strategies to reduce PLP by addressing known risk factors, specifically those identified by the current study.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Amputation / Amputation - adverse effects / Bias / Biology and Life Sciences / Clinical Decision-Making / Complications and side effects / Demographic aspects / Developed countries / Developing countries / Diagnosis / Engineering and Technology / Epidemiology / Health risks / Heterogeneity / Humans / LDCs / Leg amputation / Medicine / Medicine and Health Sciences / Meta-analysis / Neurosciences / Nursing / Pain / Pain management / Phantom limb / Phantom Limb - epidemiology / Phantom Limb - etiology / Physical Sciences / Prevalence / Research and Analysis Methods / Risk analysis / Risk Factors / Statistical analysis / Systematic review