Predictors of treatment failure pain among patients with mine-explosive wounds

Background: 83.3% of patients after mine-explosive injuries received during hostilities in Ukraine have negative results of pain treatment, which leads to its chronicity. Identifying predictors of negative pain outcomes in these patients may improve their treatment outcomes. Methods The treatment of 660 patients was analyzed. The results of the treatment were assessed using the visual analog scale (VAS). Comparison of groups was carried out according to the Mann-Whitney test. 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 assessed by the area under the ROC curve (AUC – Area under the ROC curve). To quantify the degree of influence of the factor characteristic, the odds ratio indicator was calculated. Results Predictors of negative results of pain treatment in patients with with mine-explosive wounds are: 1) method of pain treatment (p < 0.001), OR = 0.06 (95% CI 0.04–0.09); 2) high intensity of pain according to the VAS upon admission (p < 0.001), OR = 3.16 (95% CI 2.52–3.98); 3) anesthetic risk according to ASA (p = 0.049) OR = 0.67 (0.45–0.99); 4) set of indicators: method of pain treatment, age of the patient and number of injured anatomical parts of the body AUC = 0.82 (95% CI 0.79–0.85); 5) number of injured anatomical parts of the body (p = 0.015), OR = 1.17 (95% CI 1.03–1.32). Conclusions The conducted analysis showed that the method of pain treatment, high intensity of pain upon admission to a medical institution, anesthetic risk according to ASA is associated with a higher risk of receiving negative results of pain treatment in patients with mine-explosive injuries. Favoring the combination of pain management with regional anesthesia, controlling pain during transport to the hospital, and preventing risks related to the severity of the patient's condition can potentially improve outcomes for these patients. Trial registration ClinicalTrials.gov: Retrospectively registered on July 28, 2022 NCT05478655