Association between catastrophizing, postoperative pain, and injury severity in soldiers injured during the first year of the war in Ukraine: a cross-sectional study

Keywords: catastrophizing, postoperative pain, war injuries, soldiers, military personnel, Ukraine


Aims: The aim of this study was to investigate the association between catastrophizing, postoperative pain, and injury 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 regional 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 potential 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 catastrophizing 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 traumatic events did not contribute to the catastrophizing scores.

Conclusions: Our study describes a positive association between catastrophizing, sustained injuries, combat exposure, 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 civilian population.

Research Articles