OBJECTIVE To characterize the longitudinal course and identify predictors of chronic pain and pruritus following burn injury. DESIGN Prospective multicenter cohort study. SETTING Specialized inpatient burn rehabilitation centers. PARTICIPANTS A total of 103 adult burn survivors undergoing burn-specific inpatient rehabilitation. INTERVENTIONS burn-specific inpatient rehabilitation. MAIN OUTCOME MEASURES Pain at rest and pain on exertion were assessed using Numeric Rating Scales (NRS), whereas joint pain and pruritus were recorded as present or absent, at admission, discharge, and 3- and 12-month follow-up. Clinically significant pain was defined as NRS ≥4. RESULTS At admission, 17.5% of patients reported clinically significant pain at rest, 49.5% pain on exertion, 40.0% joint pain, and 68.0% pruritus. At 12 months, prevalence decreased to 14.1%, 30.4%, 34.8%, and 51.1%, respectively. Baseline post-traumatic stress disorder (PTSD) symptoms were independently associated with higher odds of pain at rest (OR 23.8, 95% CI 3.58-347.0), pain on exertion (OR 10.5, 95% CI 3.56-36.7), joint pain (OR 12.9, 95% CI 4.24-47.3), and pruritus (OR 4.36, 95% CI 1.67-12.2). All associations remained significant after correction for multiple testing. Across time points, PTSD was associated with increased joint pain (risk difference +28.96%, 95% CI 19.64%-38.29%) and pruritus (+9.7%, 95% CI 0.4%-19.1%). CONCLUSIONS Chronic pain and pruritus remain common one year after burn injury despite structured rehabilitation. PTSD was consistently associated with greater symptom burden, supporting the need for integrated psychological and somatic rehabilitation strategies.
