A systematic review of the prevalence of post amputation and chronic neuropathic pain associated with combat injury in military personnel
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Combat trauma can lead to widespread tissue damage and limb loss. This may result in chronic neuropathic and post amputation pain, including phantom limb pain (PLP) and residual limb pain (RLP). The military population is distinct with respect to demographic, injury, and social characteristics compared with other amputation and trauma cohorts. We undertook a systematic review of studies of military personnel, with a history of combat injury, that reported a prevalence of any type of postamputation pain or chronic neuropathic pain, identified from Embase and MEDLINE databases.Using the inverse variance method with a random-effects model, we undertook a meta-analysis to determine an overall prevalence and performed exploratory analyses to identify the effect of the type of pain, conflict, and time since injury on prevalence. Pain definitions and types of pain measurement tools used in studies were recorded. Thirty-one studies (14,738 participants) were included. The pooled prevalence of PLP, RLP, and chronic neuropathic pain were 57% (95% CI: 46-68), 61% (95% CI: 50-71), and 26% (95% CI: 10-54), respectively. Between-study heterogeneity was high (I2: 94%-98%). Characterisation of duration, frequency, and impact of pain was limited. Factors reported by included studies as being associated with PLP included the presence of RLP and psychological comorbidity. The prevalence of postamputation pain and chronic neuropathic pain after combat trauma is high. We highlight inconsistency of case definitions and terminology for pain and the need for consensus in future research of traumatic injury.
Date Issued
2024-04-01
Date Acceptance
2023-08-04
Citation
Pain, 2024, 165 (4), pp.727-740
ISSN
0304-3959
Publisher
Lippincott, Williams & Wilkins
Start Page
727
End Page
740
Journal / Book Title
Pain
Volume
165
Issue
4
Copyright Statement
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf
of the International Association for the Study of Pain. This is an open access article
distributed under the Creative Commons Attribution License 4.0 (CCBY), which
permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
of the International Association for the Study of Pain. This is an open access article
distributed under the Creative Commons Attribution License 4.0 (CCBY), which
permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
License URL
Identifier
https://journals.lww.com/pain/fulltext/9900/a_systematic_review_of_the_prevalence_of.472.aspx
Publication Status
Published
Date Publish Online
2023-12-15