Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury

Matthew C Mauck; Jennifer Smith; Jeffrey W Shupp; Mark A Weaver; Andrea Liu; Andrey V Bortsov; Bilal Lateef; Samuel W Jones; Felicia Williams; James Hwang; Rachel Karlnoski; David J Smith; Bruce A Cairns; Samuel A McLean

doi:10.1097/j.pain.0000000000001029

Back

Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury

Journal article

Peer reviewed

Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury

Matthew C Mauck, Jennifer Smith, Jeffrey W Shupp, Mark A Weaver, Andrea Liu, Andrey V Bortsov, Bilal Lateef, Samuel W Jones, Felicia Williams, James Hwang, …

Pain (Amsterdam), Vol.158(11), pp.2268-2276

11/2017

DOI: 10.1097/j.pain.0000000000001029

PMCID: PMC5696630

PMID: 28796116

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/5696630View

Open Access

Abstract

More than half of individuals experiencing major thermal burn injury (MThBI) receive an autologous skin graft (autograft), in which skin is removed from a healthy "donor" site and transplanted to the burn site. Persistent pain and itch at the graft site are major causes of suffering and disability in MThBI survivors. African Americans have a higher risk of MThBI, and in other clinical settings African Americans experience a greater burden of pain and itch relative to European Americans. However, to our knowledge, ethnic differences in skin graft site pain and itch outcomes after MThBI have not been assessed. We evaluated skin graft site pain and itch severity (0-10 Numeric Rating Scale [NRS]) over 1 year in a prospective multicenter cohort sample of African Americans and European Americans. In adjusted linear mixed models, African Americans experienced a slower rate of pain resolution in the acute phase of recovery (β = -0.05 vs -0.08 NRS points per day, P < 0.001), which resulted in a higher pain severity in the persistent phase of recovery (NRS mean difference = 1.21, 95% confidence interval [0.12-2.29]), although not statistically significant after correction for multiple comparisons. African Americans also experience greater itch severity in 6 weeks to 12 months after burn injury compared with European Americans (NRS mean difference = 1.86 [0.80-2.93]), which results from a faster rate of itch development in African Americans in the acute recovery phase after burn injury. Future studies may improve outcomes in African Americans and lead to new pathogenic insights that benefit all burn injury survivors.

Adult

African Americans

Analgesics - therapeutic use

Brain Injuries - complications

Brain Injuries - epidemiology

Brain Injuries - ethnology

Brain Injuries - etiology

Burns - complications

Catastrophization

European Continental Ancestry Group

Female

Follow-Up Studies

Health Status

Humans

Male

Middle Aged

Mood Disorders - etiology

Pain - drug therapy

Pain - epidemiology

Pain - etiology

Pain - psychology

Pain Measurement

Pruritus - epidemiology

Pruritus - etiology

Survivors

United States - epidemiology

Details

Title: Subtitle: Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury
Creators: Matthew C Mauck - University of North Carolina at Chapel Hill
Jennifer Smith - University of North Carolina at Chapel Hill
Jeffrey W Shupp - MedStar Washington Hospital Center
Mark A Weaver - University of North Carolina at Chapel Hill
Andrea Liu - University of North Carolina at Chapel Hill
Andrey V Bortsov - University of North Carolina at Chapel Hill
Bilal Lateef - University of North Carolina at Chapel Hill
Samuel W Jones - University of North Carolina at Chapel Hill
Felicia Williams - University of North Carolina at Chapel Hill
James Hwang - University of North Carolina at Chapel Hill
Rachel Karlnoski - University of South Florida
David J Smith - University of South Florida
Bruce A Cairns - University of North Carolina at Chapel Hill
Samuel A McLean - University of North Carolina at Chapel Hill
Resource Type: Journal article
Publication Details: Pain (Amsterdam), Vol.158(11), pp.2268-2276
DOI: 10.1097/j.pain.0000000000001029
PMID: 28796116
PMCID: PMC5696630
NLM abbreviation: Pain
ISSN: 0304-3959
eISSN: 1872-6623
Grant note: UL1 TR002489 / NCATS NIH HHS UL1 TR001111 / NCATS NIH HHS
Language: English
Date published: 11/2017
Academic Unit: Surgery
Record Identifier: 9984756266802771

Metrics

8 Record Views

15 Times Cited - Web of Science