Association between catastrophizing, postoperative pain, and injury severity in soldiers injured during the first year of the war in Ukraine

Aims: The aim of this study was to investigate the associ-ation between catastrophizing, postoperative pain, and in-jury severity following war-related injuries among soldiers injured during the first year of the war in Ukraine. Methods: This cross-sectional study included 135 patients with war-related injuries treated at the Center of Thermal Trauma and Reconstructive Surgery of the Vinnytsia re-gional University hospital in Ukraine between August 2022 and November 2022. Following surgical treatment, patients’ catastrophizing was assessed using the Ukrainian version of the Pain Catastrophizing Scale (UA-PCS) and correlated with the pain levels assessed with the numerical rating scale (NRS), and the scores obtained with Injury Severity Score (ISS) and the Combat Exposure Scale (CES). The poten-tial pre-existing traumatic events in a participant’s lifetime were assessed with The Life Events Checklist for DSM-5 (LEC-5). Results: Multiple regression analyses showed no significant association between the PCS total score and demographic variables of age, gender, marital status, education, duration of military service, or time from injury. Only 3.6% of the variance in the catastrophizing scores was accountable for the contribution of independent demographic variables. We found a moderate positive correlation between catastroph-izing scores (including all the subscales) with pain NRS, ISS, and CES scores. The pain NRS, ISS, and CES scores account for 43.4% of the variability of PCS scores. Previous traumat-ic events did not contribute to the catastrophizing scores. Conclusion: Our study describes a positive association be-tween catastrophizing, sustained injuries, combat expo-sure, and postoperative pain. Since our sample consists of injured soldiers that were young and healthy before suffering major war-related polytrauma, our study offers a unique perspective, different from all other previous studies in which catastrophizing was investigated in a ci-vilian population.