Prevalence and associated predictors for patients developing chronic neuropathic pain following burns

Kevin M Klifto; A Lee Dellon; C Scott Hultman

doi:10.1093/burnst/tkaa011

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Prevalence and associated predictors for patients developing chronic neuropathic pain following burns

更新时间：2022-06-09

- Prevalence and associated predictors for patients developing chronic neuropathic pain following burns
- Burns & Trauma Vol. 8, Issue 1, (2020)
- 作者机构：
  
  1. Department of Plastic and Reconstructive Surgery
  2. Department of Neurosurgery
- 作者简介：
- 基金信息：
- DOI：10.1093/burnst/tkaa011
  CLC：
- Published：2020，
  
  Published Online：1 May 2020，
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Kevin M Klifto, A Lee Dellon, C Scott Hultman, Prevalence and associated predictors for patients developing chronic neuropathic pain following burns, Burns & Trauma, Volume 8, 2020, tkaa011, https://doi.org/10.1093/burnst/tkaa011
DOI：

Kevin M Klifto, A Lee Dellon, C Scott Hultman, Prevalence and associated predictors for patients developing chronic neuropathic pain following burns, Burns & Trauma, Volume 8, 2020, tkaa011, https://doi.org/10.1093/burnst/tkaa011 DOI：

摘要

Abstract

BackgroundChronic pain

unrelated to the burn itself

can manifest as a long-term complication in patients sustaining burn injuries. The purpose of this study was to determine the prevalence of chronic neuropathic pain (CNP) and compare burn characteristics between patients who developed CNP and patients without CNP who were treated at a burn center.MethodsA single-center

retrospective analysis of 1880 patients admitted to the adult burn center was performed from 1 January 2014 to 1 January 2019. Patients included were over the age of 15 years

sustained a burn injury and were admitted to the burn center. CNP was diagnosed clinically following burn injury. Patients were excluded from the definition of CNP if their pain was due to an underlying illness or medication. Comparisons between patients admitted to the burn center with no pain and patients admitted to the burn center who developed CNP were performed.ResultsOne hundred and thirteen of the 1880 burn patients developed CNP as a direct result of burn injury over 5 years with a prevalence of 6.01%. Patients who developed CNP were a significantly older median age (54 years vs. 46 years

p = 0.002)

abused alcohol (29% vs. 8%

p < 0.001)

abused substances (31% vs. 9%

p < 0.001)

were current daily smokers (73% vs. 33%

p < 0.001)

suffered more full-thickness burns (58% vs. 43%

p < 0.001)

greater median percent of total body surface area (%TBSA) burns (6 vs. 3.5

p < 0.001)

were more often intubated on mechanical ventilation (33% vs. 14%

p < 0.001)

greater median number of surgeries (2 vs. 0

p < 0.001) and longer median hospital length of stay (LOS) (10 days vs. 3 days

p < 0.001)

compared to those who did not develop CNP

respectively. Median patient follow-up was 27 months.ConclusionsThe prevalence of CNP over 5 years was 6.01% in the burn center. Older ages

alcohol abuse

substance abuse

current daily smoking

greater percent of total body surface area (%TBSA) burns

third degree burns

being intubated on mechanical ventilation

having more surgeries and longer hospital LOS were associated with developing CNP following burn injury

compared to patients who did not develop CNP following burn injury.

关键词

Keywords

AlcoholBurnsChronic painLength of stayNerveNeuralgiaPrevalenceSmokingSubstanceSurgery

references

1.Rapolti M, Wu C, Schuth OA, Hultman CS. Under pressure: applying practice-based learning and improvement to the treatment of chronic neuropathic pain in patients with burns. Clin Plast Surg 2017;44:925–34.

2.Palmu R, Partonen T, Suominen K, Vuola J, Isometsa E. Functioning, disability, and social adaptation six months after burn injury. J Burn Care Res. 2016;37:e234–43.

3.Patterson DR, Tininenko J, Ptacek JT. Pain during burn hospitalization predicts long-term outcome. J Burn Care Res. 2006;27:719–26.

4.Rosenberg DB. Neurologic sequelae of minor electric burns. Arch Phys Med Rehabil. 1989;70:914–5.

5.Chudasama S, Goverman J, Donaldson JH, van Aalst J, Cairns BA, Hultman CS. Does voltage predict return to work and neuropsychiatric sequelae following electrical burn injury? Ann Plast Surg. 2010;64:522–5.

6.Deveci M, Bozkurt M, Sengezer M. Clonus: an unusual delayed neurological complication in electrical burn injury. Burns. 2001;27:647–51.

7.Browne AL, Andrews R, Schug SA, Wood F. Persistent pain outcomes and patient satisfaction with pain management after burn injury. Clin J Pain. 2011;27:136–45.

8.Tamam Y, Tamam C, Tamam B, Ustundag M, Orak M, Tasdemir N. Peripheral neuropathy after burn injury. Eur Rev Med Pharmacol Sci. 2013;17:107–11.

9.Xu D, Pollock M. Experimental nerve thermal injury. Brain. 1994;117:375–84.

10.Tu Y, Lineaweaver WC, Zheng X, Chen Z, Mullins F, Zhang F. Burn-related peripheral neuropathy: a systematic review. Burns. 2017;43:693–9.

11.Selander D, Mansson LG, Karlsson L, Svanvik J. Adrenergic vasoconstriction in peripheral nerves of the rabbit. Anesthesiology. 1985;62:6–10.

12.Parano E, Uncini A, Incorpora G, Pavone V, Trifiletti RR. Delayed bilateral median nerve injury due to low-tension electric current. Neuropediatrics. 1996;27:105–7.

13.Ono T, Matsunaga W. Traumatic neuroma: multiple lesions in the fingers occurring after deep burns. J Dermatol. 1990;17:760–3.

14.McCreery DB, Agnew WF, Yuen TG, Bullara LA. Damage in peripheral nerve from continuous electrical stimulation: comparison of two stimulus waveforms. Med Biol Eng Comput. 1992;30:109–14.

15.Lee RC. Injury by electrical forces: pathophysiology, manifestations, and therapy. Curr Probl Surg. 1997;34:677–764.

16.Ku A, Lachmann E, Tunkel R, Nagler W. Recurrent ulnar neuropathy following burn injury at elbow. Muscle Nerve. 1996;19:679.

17.Kinnunen E, Ojala M, Taskinen H, Matikainen E. Peripheral nerve injury and Raynaud's syndrome following electric shock. Scand J Work Environ Health. 1988;14:332–3.

18.Hultman CS, Erfanian K, Fraser J, Thornton SJ, Calvert CS, Cairns BA. Comprehensive management of hot-press hand injuries: long-term outcomes following reconstruction and rehabilitation. Ann Plast Surg. 2010;64:553–8.

19.Strong AL, Agarwal S, Cederna PS, Levi B. Peripheral neuropathy and nerve compression syndromes in burns. Clin Plast Surg. 2017;44:793–803.

20.Anastakis DJ, Peters WJ, Lee KC. Severe peripheral burn polyneuropathy: a case report. Burns Incl Therm Inj. 1987;13:232–5.

21.Wu C, Calvert CT, Cairns BA, Hultman CS. Lower extremity nerve decompression in burn patients. Ann Plast Surg. 2013;70:563–7.

22.Tsionos I, Leclercq C, Rochet JM. Heterotopic ossification of the elbow in patients with burns. Results after early excision. J Bone Joint Surg Br. 2004;86:396–403.

23.Henderson B, Koepke GH, Feller I. Peripheral polyneuropathy among patients with burns. Arch Phys Med Rehabil. 1971;52:149–51.

24.Margherita AJ, Robinson LR, Heimbach DM, Fishfader VL, Schneider VA, Jones D. Burn-associated peripheral polyneuropathy. A search for causative factors. Am J Phys Med Rehabil. 1995;74:28–32.

25.Chan Q, Ng K, Vandervord J. Critical illness polyneuropathy in patients with major burn injuries. Eplasty. 2010;10:e68.

26.Carver N, Logan A. Critically ill polyneuropathy associated with burns: a case report. Burns. 1989;15:179–80.

27.Henderson J, Terenghi G, McGrouther DA, Ferguson MW. The reinnervation pattern of wounds and scars may explain their sensory symptoms. J Plast Reconstr Aesthet Surg. 2006;59:942–50.

28.Hamed K, Giles N, Anderson J, Phillips JK, Dawson LF, Drummond P, et al. Changes in cutaneous innervation in patients with chronic pain after burns. Burns. 2011;37:631–7.

29.Sepulchre C, Moati F, Miskulin M, Huisman O, Moczar E, Robert AM, et al. Biochemical and pharmacological properties of a neurotoxic protein isolated from the blood serum of heavily burned patients. J Pathol. 1979;127:137–45.

30.Drummond PD. Alpha(1)-Adrenoceptors augment thermal hyperalgesia in mildly burnt skin. Eur J Pain. 2009;13:273–9.

31.Ashraf A, Mohammadi A, Roshanzamir S, Ayaz M, Tolide-ie H, Ghasempoor MZ. Sympathetic skin response in electrical burn injury. Burns. 2012;38:232–5.

32.von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495–9.

33.Gilron I, Baron R, Jensen T. Neuropathic pain: principles of diagnosis and treatment. Mayo Clin Proc. 2015;90:532–45.

(34.Schneider JC, Harris NL, El Shami A, Sheridan RL. Schulz JT,3rd, Bilodeau ML, et al. A descriptive review of neuropathic-like pain after burn injury. J Burn Care Res. 2006; 27: 524–8.

35.Choiniere M, Melzack R, Papillon J. Pain and paresthesia in patients with healed burns: an exploratory study. J Pain Symptom Manage. 1991;6:437–44.

36.Gabriel V, Kowalske KJ, Holavanahalli RK. Assessment of recovery from burn-related neuropathy by electrodiagnostic testing. J Burn Care Res. 2009;30:668–74.

37.Dauber A, Osgood PF, Breslau AJ, Vernon HL, Carr DB. Chronic persistent pain after severe burns: a survey of 358 burn survivors. Pain Med. 2002;3:6–17.

38.Khedr EM, Khedr T, el-Oteify MA, Hassan HA. Peripheral neuropathy in burn patients. Burns. 1997;23:579–83.

39.Malenfant A, Forget R, Papillon J, Amsel R, Frigon JY, Choiniere M. Prevalence and characteristics of chronic sensory problems in burn patients. Pain. 1996;67:493–500.

40.Ward RS, Saffle JR, Schnebly WA, Hayes-Lundy C, Reddy R. Sensory loss over grafted areas in patients with burns. J Burn Care Rehabil. 1989;10:536–8.

41.Carroll I, Hah J, Mackey S, Ottestad E, Kong JT, Lahidji S, et al. Perioperative interventions to reduce chronic postsurgical pain. J Reconstr Microsurg. 2013;29:213–22.

42.Carroll I. Pharmacologic Management of Upper Extremity Chronic Nerve Pain. Hand Clin. 2016;32:51–61.

43.Camara CC, Araujo CV, de Sousa KKO, Brito GAC, Vale ML, Raposo RDS, et al. Gabapentin attenuates neuropathic pain and improves nerve myelination after chronic sciatic constriction in rats. Neurosci Lett. 2015;607:52–8.

44.Moores J. Vitamin C: a wound healing perspective. Br J Community Nurs. 2013;S6:S8–11.

45.Gray P, Kirby J, Smith MT, Cabot PJ, Williams B, Doecke J, et al. Pregabalin in severe burn injury pain: a double-blind, randomised placebo-controlled trial. Pain. 2011;152:1279–88.

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