Pain after combat injury in male UK military personnel deployed to Afghanistan.

Autor:	Vollert J; Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; Pain Research, MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK. Electronic address: j.vollert@exeter.ac.uk., Kumar A; Pain Research, MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, Loughborough, UK., Coady EC; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK., Cullinan P; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK., Dyball D; King's Centre for Military Health Research, King's College London, London, UK., Fear NT; King's Centre for Military Health Research, King's College London, London, UK; Academic Department of Military Mental Health, King's College London, London, UK., Gan Z; Pain Research, MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK., Miller EF; Department of Bioengineering, Faculty of Engineering, Imperial College London, London, UK., Sprinckmoller S; Department of Bioengineering, Faculty of Engineering, Imperial College London, London, UK., Schofield S; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK., Bennett A; Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, Loughborough, UK; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK., Bull AMJ; Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, London, UK., Boos CJ; Department of Cardiology, University Hospital Dorset, NHS Trust, Poole, UK., Rice ASC; Pain Research, MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, London, UK., Kemp HI; Pain Research, MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2024 Jun; Vol. 132 (6), pp. 1285-1292. Date of Electronic Publication: 2024 Mar 23.
DOI:	10.1016/j.bja.2024.02.019
Abstrakt:	Background: Chronic pain after injury poses a serious health burden. As a result of advances in medical technology, ever more military personnel survive severe combat injuries, but long-term pain outcomes are unknown. We aimed to assess rates of pain in a representative sample of UK military personnel with and without combat injuries. Methods: We used data from the ADVANCE cohort study (ISRCTN57285353). Individuals deployed as UK armed forces to Afghanistan were recruited to include those with physical combat injuries, and a frequency-matched uninjured comparison group. Participants completed self-reported questionnaires, including 'overall' pain intensity and self-assessment of post-traumatic stress disorder, anxiety, and depression. Results: A total of 579 participants with combat injury, including 161 with amputations, and 565 uninjured participants were included in the analysis (median 8 yr since injury/deployment). Frequency of moderate or severe pain was 18% (n=202), and was higher in the injured group (n=140, 24%) compared with the uninjured group (n=62, 11%, relative risk: 1.1, 95% confidence interval [CI]: 1.0-1.2, P<0.001), and lower in the amputation injury subgroup (n=31, 19%) compared with the non-amputation injury subgroup (n=109, 26%, relative risk: 0.9, 95% CI: 0.9-1.0, P=0.034). Presence of at least moderate pain was associated with higher rates of post-traumatic stress (RR: 3.7, 95% CI: 2.7-5.0), anxiety (RR: 3.2, 95% CI: 2.4-4.3), and depression (RR: 3.4, 95% CI: 2.7-4.5) after accounting for injury. Conclusion: Combat injury, but not amputation, was associated with a higher frequency of moderate to severe pain intensity in this cohort, and pain was associated with adverse mental health outcomes. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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