Intensive & critical care nursing · 2025
Chronic pain in ICU survivors: Potential risk factors and relationship with post-traumatic stress disorder symptoms and health related quality of life.
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Giannelou Evangelia, Papathanassoglou Elizabeth, Karanikola Maria, Giannakopoulou Margarita, Bozas Evangelos, Skopeliti Niki, Mpouzika Meropi
Аннотация
OBJECTIVES: To identify patient characteristics and clinical factors during ICU hospitalization potentially associated with chronic pain occurrence, and to determine its relationship with symptoms of post-traumatic stress disorder (PTSD) and health-related quality of life (HRQoL) at three time points after ICU discharge.
METHODS: Adult ICU survivors were enrolled in a prospective, repeated measures study. The study was carried out in two phases. Phase I was conducted during the first 5 days of survivors' ICU hospitalization where patient characteristics and clinical data were collected. Phase II was conducted via telephone interviews after 3 (T1), 6 (T2) and 12 (T3) months post-ICU discharge, where pain, PTSD-related symptoms, and HRQoL were assessed with the Numeric Rating Scale (NRS), Davidson Trauma Scale (DTS), and 36-Item Short Form Survey version 2 (SF-36v2), respectively.
RESULTS: Data from 59 survivors were analysed, 69.5% of whom were males. The sample's mean age was 52.7 (SD 18.9) years and 62.7% of them reported NRS>3 at T1, indicating chronic pain. After adjusting for sex, age, and APACHE II score, chronic pain was significantly associated with: (a) length of stay in the ICU (OR=1.42; 95%CI: 1.03-1.95; p=0.030) and (b) clinically relevant symptoms of PTSD at T1 (OR=10.04; 95%CI: 2.44-41.24; p=0.001) and T2 (OR=11.90; 95%CI: 1.28-110.49; p=0.029). Lower SF-36v2 scores in all domains at T1, several domains at T2, and two domains at T3 were significantly associated with CP occurrence.
CONCLUSIONS: Of the patient characteristics and clinical factors analysed, only longer length of stay in ICU was significantly associated with higher odds of chronic pain occurrence, which in turn was linked to PTSD-related symptoms and lower HRQoL after ICU discharge.
IMPLICATIONS FOR CLINICAL PRACTICE: Clinical interventions aimed at optimizing ICU length of stay, such as the implementation of early mobility programs and multidisciplinary rehabilitation, may support prevention of chronic pain occurrence and improve long-term outcomes.
METHODS: Adult ICU survivors were enrolled in a prospective, repeated measures study. The study was carried out in two phases. Phase I was conducted during the first 5 days of survivors' ICU hospitalization where patient characteristics and clinical data were collected. Phase II was conducted via telephone interviews after 3 (T1), 6 (T2) and 12 (T3) months post-ICU discharge, where pain, PTSD-related symptoms, and HRQoL were assessed with the Numeric Rating Scale (NRS), Davidson Trauma Scale (DTS), and 36-Item Short Form Survey version 2 (SF-36v2), respectively.
RESULTS: Data from 59 survivors were analysed, 69.5% of whom were males. The sample's mean age was 52.7 (SD 18.9) years and 62.7% of them reported NRS>3 at T1, indicating chronic pain. After adjusting for sex, age, and APACHE II score, chronic pain was significantly associated with: (a) length of stay in the ICU (OR=1.42; 95%CI: 1.03-1.95; p=0.030) and (b) clinically relevant symptoms of PTSD at T1 (OR=10.04; 95%CI: 2.44-41.24; p=0.001) and T2 (OR=11.90; 95%CI: 1.28-110.49; p=0.029). Lower SF-36v2 scores in all domains at T1, several domains at T2, and two domains at T3 were significantly associated with CP occurrence.
CONCLUSIONS: Of the patient characteristics and clinical factors analysed, only longer length of stay in ICU was significantly associated with higher odds of chronic pain occurrence, which in turn was linked to PTSD-related symptoms and lower HRQoL after ICU discharge.
IMPLICATIONS FOR CLINICAL PRACTICE: Clinical interventions aimed at optimizing ICU length of stay, such as the implementation of early mobility programs and multidisciplinary rehabilitation, may support prevention of chronic pain occurrence and improve long-term outcomes.