Chronic pain in intensive care unit survivors: incidence, characteristics and side-effects up to one-year post-discharge.

BACKGROUND Intensive care unit survivors experience significant physical and psychological problems, including chronic pain following discharge. The aim of this study was to observe the incidence, anatomical sites, intensity, and interference of chronic pain in intensive care unit survivors over a 1-year period. In addition, potential predictors of chronic pain were analysed. METHODS Data were collected during an intensive care unit follow-up programme as part of a quality improvement initiative. Data from the Brief Pain Inventory and from musculoskeletal assessment were examined, alongside demographic data from the patient. Data were collected from patients at baseline and at a 1-year follow-up appointment. RESULTS Data from 47 intensive care unit survivors were included in this study. In 66% (n = 31) of the patients a "new" chronic pain that did not exist before their stay in the intensive care, was reported. Pain intensity in this patient group was "moderate"' and did not improve significantly over the 1-year period. Although pain interference with life decreased over the study period, it was still the most common cause of reduced enjoyment of life and reduced employment at 1-year follow-up. CONCLUSION Chronic pain is associated with morbidity in intensive care unit survivors. Pain interference, but not pain intensity, improved significantly in the first year after discharge. Further multi-centre research is required to elucidate the chronic pain experience.

[1]  E. Ely,et al.  Critical Care Pharmacists and Medication Management in an ICU Recovery Center , 2018, The Annals of pharmacotherapy.

[2]  T. Iwashyna,et al.  Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE). Early evaluation of a complex intervention , 2017, PloS one.

[3]  T. Iwashyna,et al.  Peer support to improve recovery following critical care discharge: a case-based discussion , 2017, Thorax.

[4]  J. McPeake,et al.  Caregiver strain following critical care discharge: An exploratory evaluation. , 2016, Journal of critical care.

[5]  J. Jahnsen,et al.  Validity, Reliability, and Responsiveness of the Brief Pain Inventory in Inflammatory Bowel Disease , 2016, Canadian journal of gastroenterology & hepatology.

[6]  D. Needham,et al.  Exploring the Scope of Post–Intensive Care Syndrome Therapy and Care: Engagement of Non–Critical Care Providers and Survivors in a Second Stakeholders Meeting , 2014, Critical care medicine.

[7]  H. Hutchings,et al.  Chronic pain in survivors of critical illness: a retrospective analysis of incidence and risk factors , 2013, Critical Care.

[8]  C. Jenkinson,et al.  An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study , 2013, Critical Care.

[9]  Chris R Brewin,et al.  Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study , 2012, Critical Care.

[10]  Kathleen Puntillo,et al.  The transition from acute to chronic pain: might intensive care unit patients be at risk? , 2012, Annals of Intensive Care.

[11]  D. Needham,et al.  Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders' conference* , 2012, Critical care medicine.

[12]  T. Iwashyna Survivorship Will Be the Defining Challenge of Critical Care in the 21st Century , 2010, Annals of Internal Medicine.

[13]  K. Stavem,et al.  Cutpoints for mild, moderate and severe pain in patients with osteoarthritis of the hip or knee ready for joint replacement surgery , 2008, BMC musculoskeletal disorders.

[14]  S. Wallenstein,et al.  A randomized, double-blind, placebo-controlled, two-period, crossover, pilot trial of lamotrigine in patients with central pain due to multiple sclerosis. , 2007, Clinical therapeutics.

[15]  P. Keck,et al.  Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. , 2007, Arthritis and rheumatism.

[16]  M. Podbregar,et al.  Long-term outcome and quality of life of patients treated in surgical intensive care: a comparison between sepsis and trauma , 2006, Critical care.

[17]  B. Collett,et al.  Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment , 2006, European journal of pain.

[18]  M. Jensen,et al.  Validation of the Brief Pain Inventory for chronic nonmalignant pain. , 2004, The journal of pain : official journal of the American Pain Society.

[19]  J. Farrar,et al.  Core outcome domains for chronic pain clinical trials: IMMPACT recommendations , 2003, Pain.

[20]  M. Zalon,et al.  Comparison of Pain Measures in Surgical Patients , 1999, Journal of Nursing Measurement.

[21]  C. Cleeland The Brief Pain Inventory User Guide , 2009 .