251) PTSD influences pain and itch symptoms overtime following MThBI

Persistent pain and itch are common, morbid outcomes in survivors of major thermal burn injury (MThBI) and significantly affect survivor quality of life. Increasing evidence suggests that the pathophysiology of pain and itch share overlapping mechanisms, and that these mechanisms relate to neuro/stress/immune mechanisms which are involved in the pathogenesis of posttraumatic stress disorder symptoms (PTSD). In addition, PTSD symptoms may drive neurobiologic changes which contribute to the persistence of pain and itch. For these reasons, we hypothesized that PTSD symptoms in the early aftermath of MThBI would predict pain and itch outcomes. To test this hypothesis, we examined the relationship between PTSD symptoms (PTSD Symptom Scale Interview) assessed within 72 hours of hospital admission in a cohort of individuals (n = 96) admitted to one of 3 hospitals for MThBI and tissue autograft pain and itch outcomes (0-10 NRS) at 3, 6, 12, and 24 weeks. In linear regression models adjusted for age, sex, and ethnicity (African American vs. European American), initial PTSD symptom severity significantly predicted pain outcomes and itch outcomes at each time point, with strength of prediction increasing over time. For example, β = 0.303, p =0.006 for itch prediction at 6 weeks vs. β = 0.327, p = 0.003 for itch prediction at 24 weeks; β = 0.277, p = 0.012 for pain prediction at 6 weeks vs. β = 0.327, p = 0.003 for pain prediction at 24 weeks. The strength of association between PTSD severity and itch is greater than for pain. These data indicate that PTSD symptoms in the early aftermath of MThBI predict pain and itch outcomes. Further studies are needed to determine if such symptoms may contribute to risk identification and to understand pathophysiologic mechanisms accounting for these associations.