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. 2024 May 1;279(5):874-879.
doi: 10.1097/SLA.0000000000006146. Epub 2023 Nov 2.

Neuropathic Pain After Burn Injury: A Severe and Common Problem in Recovery

Eloise Stanton  1 , Kara McMullen  2 , Paul Won  1 , Jeffrey C Schneider  3 , Colleen Ryan  4 , Gretchen Carrougher  5 , Karen Kowalske  6 , Haig A Yenikomshian  1
Affiliations

Neuropathic Pain After Burn Injury: A Severe and Common Problem in Recovery

Eloise Stanton et al. Ann Surg. .

Abstract

Objective: The aim of this study was to address the limited understanding of neuropathic pain (NP) among burn survivors by comprehensively examining its prevalence and related factors on a national scale using the Burn Model System (BMS) National Database.

Background: NP is a common but underexplored complaint among burn survivors, greatly affecting their quality of life and functionality well beyond the initial injury. Existing data on NP and its consequences in burn survivors are limited to select single-institution studies, lacking a comprehensive national perspective.

Methods: The BMS National Database was queried to identify burn patients responding to NP-related questions at enrollment, 6 months, 12 months, 2 years, and 5 years postinjury. Descriptive statistics and regression analyses were used to explore associations between demographic/clinical characteristics and self-reported NP at different time points.

Results: There were 915 patients included for analysis. At discharge, 66.5% of patients experienced NP in their burn scars. Those with NP had significantly higher Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) pain inference, itch, anxiety, depression, and sleep disturbance scores and were less able to partake in social roles. Multiple logistic regression revealed male sex, % total body surface area, and moderate-to-severe pain as predictors of NP at 6 months. At 12 months, % total body surface area and moderate-to-severe pain remained significant predictors, while ethnicity and employment status emerged as significant predictors at 24 months.

Conclusions: This study highlights the significant prevalence of NP in burn patients and its adverse impacts on their physical, psychological, and social well-being. The findings underscore the necessity of a comprehensive approach to NP treatment, addressing both physical symptoms and psychosocial factors.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
a) PROMIS-29 pain interference scores were significantly greater in the NP group at all follow-up points. b) PROMIS-29 itch scores were significantly in the NP group at all time points after 6-months follow-up. c) PROMIS-29 physical function and social roles scores - The NP group had significantly lower PROMIS029 physical functioning scores and were significantly less likely to be able to engage in social activities compared the group without NP. d) PROMIS-29 psychological function scores - The NP group had significantly higher anxiety, depression, fatigue, and sleep disturbance scores at all follow-up points
Figure 1.
Figure 1.
a) PROMIS-29 pain interference scores were significantly greater in the NP group at all follow-up points. b) PROMIS-29 itch scores were significantly in the NP group at all time points after 6-months follow-up. c) PROMIS-29 physical function and social roles scores - The NP group had significantly lower PROMIS029 physical functioning scores and were significantly less likely to be able to engage in social activities compared the group without NP. d) PROMIS-29 psychological function scores - The NP group had significantly higher anxiety, depression, fatigue, and sleep disturbance scores at all follow-up points
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