Predictors of chronic pain, chronic opioid use and neuropathic pain in Ukrainian military patients with isolated thoracic injuries sustained during the Russia-Ukraine conflict: a single-centre prospective observational study.

Abstract

Purpose: The aim of this study was to investigate the rate and predictors of (a) chronic pain, (b) chronic opioid use and (c) neuropathic pain in Ukrainian military patients with isolated thoracic injuries sustained during the Russia-Ukraine Conflict.

Methods: A prospective, single-centre observational study design was used. Military patients (≥ 16 years old) with isolated thoracic injuries, admitted to a frontline hospital in Ukraine for ≥ 24 h were included. At three-months post-injury, baseline data were collected retrospectively from the participants' hospital records and the Eq. 5D-5 L, PROMIS-PI, and PainDETECT surveys completed with either face to face in the follow-up appointment, or by telephone. Predictors of chronic pain, chronic opioid use and neuropathic pain were investigated using multivariate logistic regression modelling.

Results: 101 patients were included; 85 (85%) were male, with a median age of 38 (IQR: 33-44). Median number of ribs fractures was six (IQR: 5-8), with 62 (62%) patients sustaining burns to the thorax, and 34 (34%) presenting with one or more thoracic spinal fracture. A total of 61 (61%) of patients reported chronic pain, 55 (55%) reported chronic opioid use and 74 (74%) reported neuropathic pain at three months. Positive predictors for chronic pain at three months post-injury were an increasing hospital length of stay, bilateral rib fractures, thoracic burns and one or more thoracic spinal fracture (all p < 0.05).

Conclusion: This study provides an overview of the rate and predictors of chronic pain, chronic opioid use and neuropathic pain at three months, in military patients with isolated thoracic injuries.