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

Abstract

Objective: 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. Summary Background Data: 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, six months, 12 months, two years, and five years post-injury. 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 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, %TBSA, and moderate-to-severe pain as predictors of NP at six months. At 12 months, %TBSA 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.