62 Pain and PTSD Severity are Reciprocally Related in Burn Survivors at 6 months Post-Discharge
Bibliographic record
Abstract
Following autograft, 28% of burn survivors report moderate-severe graft site pain at 6 weeks and 21% at 6 months. Additionally, an estimated 2–40% of burn survivors have posttraumatic stress disorder (PTSD) 3–6 months post-burn. While both pain and PTSD are common in burn survivors, examination of their impact on one another in these individuals is limited. The present study aimed to investigate this relationship in burn survivors, specifically evaluating the applicability of the Mutual Maintenance Model (MMM), which proposes that pain and PTSD are reciprocally related. Burn Model System data (1994 to 2014) were analyzed. Independent variables (IVs) included acute pain at discharge, or Acute Pain-DC (measured by McGill Pain Questionnaire-Short Form, or SF-MPQ), and PTSD at 6 months, or PTSD-6 (measured by Davidson Trauma Scale), and the outcome was chronic pain at 6 months post-discharge, or Chronic Pain-6 (measured by SF-MPQ). A linear regression was used to examine whether the IVs and their interaction (Acute Pain-DC X PTSD-6) were associated with Chronic Pain-6. Post-hoc multivariate linear regressions investigating the Chronic Pain-6 subscales, Affective Pain and Sensory Pain, were also completed. Sample characteristics (N= 166 with complete data) included: Caucasian (70%), male (69%), mean age 42 years (SD = 15). Injury severity descriptors included: mean TBSA burned 14.65% (SD = 15.6), and length of stay 21.5 days (SD = 23.4). The overall regression model for Chronic Pain-6 was significant (R2 = 0.45, p = 0.000); PTSD-6 was the only significant IV (β = 0.29, p = 0.019). The overall model for Chronic Pain-6 (Affective) was also significant (R2 = 0.42, p = 0.000), with PTSD-6 being the only significant IV (β = 0.48, p = 0.000). The overall model for the Chronic Pain-6 (Sensory) was significant (R2 = 0.42, p = 0.000), as well. Notably, the only significant IV in this model was the interaction between PTSD-6 and Acute Pain-DC (Sensory). See Figure 1 for detailed results. As hypothesized, the MMM was supported: chronic PTSD-6 was significantly associated with Chronic Pain-6. Results also indicate that the interaction of Acute Pain-DC (Sensory) and Chronic PTSD-6 was significantly related to Chronic Pain-6 (Sensory). PTSD and Pain are reciprocally related at 6 months; efforts to prevent or treat them in acute care and rehabilitation will likely reduce their chronicity. Potential mechanisms and possible interventions will be presented.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".