The relationship of chronic pain with performed surgical interventions and injured anatomical parts of the body in patients with gunshot and mine-explosive wounds at the stages of treatment

Abstract

Resume. Chronic pain in injured patients is a negative outcome of pain management in the stages of treatment. Chronic pain is diagnosed in 83.3% of patients with mine-explosive wounds, and in 70% of patients with gunshot wounds. The frequency of chronic pain also depends on the type of injury and the number of injured anatomical parts of the body. So, in patients with gunshot wounds in 1 or 2 anatomical parts of the body, chronic pain is diagnosed in 69.7% of cases, and in 3 or more cases - in 71.2% of cases. Also, in patients with mine-explosive wounds - 82.2% and 91.7% of cases, respectively. Patients in civilian life who have received serious injuries suffer from chronic pain in 11-40% of cases. Considering the high frequency of chronic pain in this category of patients, the study of the relationship between the operations performed and the injured anatomical parts of the body in patients with gunshot and mine-explosive wounds at the stages of treatment with chronic pain will play an important role, and will also contribute to the improvement of the treatment of this category of patients .
 The goal of the work. To investigate the relationship of chronic pain with performed surgical interventions and injured anatomical parts of the body in patients with gunshot and mine-explosive wounds at the stages of treatment.
 Materials and methods. Study of patients with gunshot and mine-explosive injuries. The tool for pain intensity research was a visual analog scale. The method of constructing univariate and multivariate logistic regression models was used to analyze the relationship between the risks of receiving a negative treatment result and factor characteristics. The quality of the models was evaluated by the area under the ROC curve. To quantify the degree of influence of the factor characteristic, the odds ratio indicator was calculated.
 Results of the research. Studying the relationship of chronic pain with performed surgical interventions and injured anatomical parts of the body in patients with gunshot and mine-explosive wounds at the stages of treatment, it was found that there is a relationship (AUC=0.54 95% CI 0.51-0.57) of the risk of chronicity pain with the number of injured anatomical parts of the body - with the number of injured 3 or more, the risk of pain chronicity increases (p=0.010), OR=1.45 (95% CI 1.09-1.92) compared to patients who have injured 1 or 2 parts of the body. Also, two factors related to the risk of chronic pain were found - the number of injured anatomical parts of the body and the type of injury, AUC=0.56 (95% CI 0.53-0.59).
 Conclusions. The tactics of pain treatment in patients with gunshot and mine-explosive wounds at the stages of treatment should take into account the type of injury and the number of injured anatomical parts of the body. This, potentially, can reduce cases of chronic pain, and will also contribute to the improvement of treatment results for this category of patients.