Contributors: Nantes Université (Nantes Univ); Hôtel-Dieu de Nantes; Hôpital Maison Blanche; Hôpital universitaire Robert Debré Reims (CHU Reims); Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon; Hôpital Edouard Herriot CHU - HCL; Hospices Civils de Lyon (HCL); BIOMERIEUX Lyon, France; Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital Lausanne (CHUV); Hôpital d'instruction des Armées Percy; Service de Santé des Armées; Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ); Pharmacologie des anti-infectieux et antibiorésistance U 1070 (PHAR2 Poitiers ); Université de Poitiers = University of Poitiers (UP)-Institut National de la Santé et de la Recherche Médicale (INSERM); Université de Poitiers – UFR Santé Faculté de Médecine et de Pharmacie (UFR Santé Poitiers ); Université de Poitiers = University of Poitiers (UP); Centre hospitalier de Saint-Nazaire; Groupe Hospitalier Bretagne Sud (GHBS); Hôpital Claude Huriez Lille; Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou; Oncogenesis, Stress, Signaling (OSS); Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC); UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM); CHU Rouen; Normandie Université (NU); CHU Trousseau Tours; Centre Hospitalier Régional Universitaire de Tours (CHRU Tours); CHRU Brest - Département d'Anesthésie Réanimation (CHU - BREST - DAR); Centre Hospitalier Régional Universitaire de Brest (CHRU Brest); Optimisation des régulations physiologiques (ORPHY (EA 4324)); Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM); Université de Brest (UBO)-Université de Brest (UBO); Institut Gustave Roussy (IGR); Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)); École Pratique des Hautes Études (EPHE); Université Paris Sciences et Lettres (PSL)-Université Paris Sciences et Lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité); CH Aubagne; Hôpital de Hautepierre Strasbourg; Hôpitaux Universitaires de Strasbourg (HUS); CHBA Vannes; Hôpital d'Instruction des Armées Clermont Tonnerre; Centre Hospitalier de Cholet (CH Cholet); Centre Hospitalier Universitaire de Saint-Etienne CHU Saint-Etienne (CHU ST-E); Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI); Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE); Nantes Université - pôle Santé; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ); methodS in Patients-centered outcomes and HEalth ResEarch (SPHERE); Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR des Sciences Pharmaceutiques et Biologiques (Nantes Univ - UFR Pharmacie); Amélie Yavchitz, Stéphanie Sigault, Aurélien Mazereaud, Lucilia Bezu, Maxime Léger, Jean-Noël Evain
Abstract: International audience ; Background Prevalence, risk factors and medical management of persistent pain symptoms after critical care illness have not been thoroughly investigated. Methods We performed a prospective multicentric study in patients with an intensive care unit (ICU) length of stay ≥ 48 h. The primary outcome was the prevalence of significant persistent pain, defined as a numeric rating scale (NRS) ≥ 3, 3 months after admission. Secondary outcomes were the prevalence of symptoms compatible with neuropathic pain (ID-pain score > 3) and the risk factors of persistent pain. Results Eight hundred fourteen patients were included over a 10-month period in 26 centers. Patients had a mean age of 57 (± 17) years with a SAPS 2 score of 32 (± 16) (mean ± SD). The median ICU length of stay was 6 [4–12] days (median [interquartile]). At 3 months, the median intensity of pain symptoms was 2 [1–5] in the entire population, and 388 (47.7%) patients had significant pain. In this group, 34 (8.7%) patients had symptoms compatible with neuropathic pain. Female (Odds Ratio 1.5 95% CI [1.1–2.1]), prior use of anti-depressive agents (OR 2.2 95% CI [1.3–4]), prone positioning (OR 3 95% CI [1.4–6.4]) and the presence of pain symptoms on ICU discharge (NRS ≥ 3) (OR 2.4 95% CI [1.7–3.4]) were risk factors of persistent pain. Compared with sepsis, patients admitted for trauma (non neuro) (OR 3.5 95% CI [2.1–6]) were particularly at risk of persistent pain. Only 35 (11.3%) patients had specialist pain management by 3 months. Conclusions Persistent pain symptoms were frequent in critical illness survivors and specialized management remained infrequent. Innovative approaches must be developed in the ICU to minimize the consequences of pain. Trial registration. NCT04817696. Registered March 26, 2021.
Processing Request
No Comments.