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Persistent neuropathic pain symptoms after FPV drone-related thoracic blast injury without rib fractures: a pilot
Ceri Battle1,2, Edward Baker3,4, Jacopo Davide Giamello5
1Physiotherapy Department, Morriston Hospital, Swansea, Wales, UK. Ceri.battle@Wales.nhs.uk.
Purpose:
The aim of this exploratory pilot study was to describe First Person View drone (FPV) related, blast-mechanism thoracic trauma with no rib fractures in Ukrainian military patients sustained during the Russia-Ukraine Conflict, and report the prevalence of persistent neuropathic pain symptoms at three months among patients admitted to a rehabilitation and pain medicine service.
Methods:
A retrospective, single-centre observational, exploratory study design was used. Military patients (≥ 16 years old) with blast-mechanism thoracic injuries with no rib fractures, admitted to a hospital's rehabilitation and pain medicine service in Ukraine for ≥ 24 h were included. The PainDETECT survey was completed at three months post-injury. Participant characteristics were summarised using descriptive statistics. Exploratory univariate and multivariate analyses were performed to explore possible associations between variables and the development of persistent neuropathic pain symptoms.
Results:
217 patients were included in the final analysis. Median age was 39 years (IQR: 32-47.5). 131 (60.4%) patients were admitted to critical care with 91 (41.9%) patients requiring mechanical ventilation. The median hospital length of stay was 22 days (IQR: 16-25) and critical care length of stay was 4 days (IQR: 2-5). Persistent neuropathic pain symptoms were reported in 173 out of 217 patients (79.7% absolute event rate). Univariate analysis revealed a stark contrast in absolute rates based on the mechanism: 99.4% (172/173) of patients exposed to blasts developed persistent symptoms compared to just 0.6% (1/45) in the low-energy and bullet-like injury group, representing an absolute risk difference of 0.97 (95% CI: 0.93-0.99, p < 0.001).
Conclusions:
The results of this pilot study demonstrate a very high rate of persistent neuropathic pain symptoms at three months in this cohort of military patients admitted to a rehabilitation and pain medicine service, highlighting significant implications for rehabilitation of long-term complications. We highlight that FPV-drone blasts can lead to significant soft tissue injuries to the thorax, in the absence of rib fractures.
