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Risk factors and events in the adult intensive care unit associated with pain as self-reported at the end of the intensive care unit stay.
Kalfon, Pierre; Boucekine, Mohamed; Estagnasie, Philippe; Geantot, Marie-Agnès; Berric, Audrey; Simon, Georges; Floccard, Bernard; Signouret, Thomas; Fromentin, Mélanie; Nyunga, Martine; Audibert, Juliette; Ben Salah, Adel; Mauchien, Bénédicte; Sossou, Achille; Venot, Marion; Robert, René; Follin, Arnaud; Renault, Anne; Garrouste-Orgeas, Maïté; Collange, Olivier; Levrat, Quentin; Villard, Isabelle; Thevenin, Didier; Pottecher, Julien; Patrigeon, René-Gilles; Revel, Nathalie; Vigne, Coralie; Azoulay, Elie; Mimoz, Olivier; Auquier, Pascal; Baumstarck, Karine.
Afiliação
  • Kalfon P; Réanimation polyvalente, Hôpital Louis Pasteur, Centre Hospitalier de Chartres, Le Coudray, 28018, Chartres Cedex, France. pkalfon@ch-chartres.fr.
  • Boucekine M; Unité de recherche EA3279, Aix-Marseille Université, Marseille, France.
  • Estagnasie P; Réanimation, Clinique Ambroise Paré, Neuilly/Seine, France.
  • Geantot MA; Département d'Anesthésie Réanimation, CHU Dijon Bourgogne, Dijon, France.
  • Berric A; Réanimation polyvalente, Centre Hospitalier Intercommunal Toulon/La Seyne sur mer, Toulon, France.
  • Simon G; Réanimation, CH Troyes, Troyes, France.
  • Floccard B; Réanimation polyvalente, CHU Édouard Herriot, Hospices Civils de Lyon, Lyon, France.
  • Signouret T; Réanimation, Hôpital Européen de Marseille, Marseille, France.
  • Fromentin M; Réanimation chirurgicale, CHU Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
  • Nyunga M; Réanimation polyvalente, CH Victor Provo, Roubaix, France.
  • Audibert J; Réanimation polyvalente, Hôpital Louis Pasteur, Centre Hospitalier de Chartres, Le Coudray, 28018, Chartres Cedex, France.
  • Ben Salah A; Réanimation polyvalente, Hôpital Louis Pasteur, Centre Hospitalier de Chartres, Le Coudray, 28018, Chartres Cedex, France.
  • Mauchien B; Réanimation polyvalente, Hôpital Louis Pasteur, Centre Hospitalier de Chartres, Le Coudray, 28018, Chartres Cedex, France.
  • Sossou A; Réanimation, CH Émile Roux, Le Puy-en-Velay, France.
  • Venot M; Réanimation médicale, CHU Saint-Louis, AP-HP, Paris, France.
  • Robert R; Réanimation médicale, CHU La Milétrie, Poitiers, France.
  • Follin A; Réanimation chirurgicale, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
  • Renault A; Réanimation médicale, CHU Brest, Brest, France.
  • Garrouste-Orgeas M; Médecine intensive et reanimation, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
  • Collange O; Réanimation chirurgicale polyvalente, Hôpital Civil, CHU Strasbourg, Strasbourg, France.
  • Levrat Q; Réanimation, Groupe Hospitalier de La Rochelle-Ré-Aunis, La Rochelle, France.
  • Villard I; Anesthésie Réanimation, CHU Beaujon, AP-HP, Clichy, France.
  • Thevenin D; Réanimation, CH Lens, Lens, France.
  • Pottecher J; Réanimation Chirurgicale, Hôpital Hautepierre, CHU Strasbourg, Strasbourg, France.
  • Patrigeon RG; Réanimation, CH Auxerre, Auxerre, France.
  • Revel N; Réanimation Médico-Chirurgicale, Hôpital Pasteur, CHU Nice, Nice, France.
  • Vigne C; Réanimation Chirurgicale, CHU Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
  • Azoulay E; Réanimation médicale, CHU Saint-Louis, AP-HP, Paris, France.
  • Mimoz O; Réanimation médicale, CHU La Milétrie, Poitiers, France.
  • Auquier P; Unité de recherche EA3279, Aix-Marseille Université, Marseille, France.
  • Baumstarck K; Unité de recherche EA3279, Aix-Marseille Université, Marseille, France.
Crit Care ; 24(1): 685, 2020 12 07.
Article em En | MEDLINE | ID: mdl-33287910
ABSTRACT

BACKGROUND:

The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically ill patients during the whole ICU stay as self-reported by patients at the end of their ICU stay.

METHODS:

The study involved 34 ICUs. Adult patients who survived an ICU stay of 3 calendar days or more were eligible for inclusion. Discomforts, including the pain-related discomfort, were assessed using the French 18-item questionnaire on discomfort in ICU patients, the "Inconforts des Patients de REAnimation" (IPREA). Patients scored each item from 0 (minimal discomfort) to 10 (maximal discomfort). Associations between patient characteristics at ICU admission, life support therapies and main potentially painful procedures performed during the ICU stay and pain-related discomfort scores assessed at the end of the ICU stay were analyzed.

RESULTS:

Patients with complete IPREA questionnaires (n = 2130) were included. The median pain-related discomfort score was 3 (IQR 0-5). From the univariate analysis, pain-related discomfort scores were negatively correlated with age and positively correlated with ICU stay duration; surgical patients reported significant higher pain-related discomfort scores than medical patients; chest drain insertion, chest drain removal, use of bladder catheter, central venous catheter (CVC) insertion, complex dressing change, and intra-hospital transport were associated with pain-related discomfort scores. From the multivariate analyses using generalized estimating equations models, only age, chest drain removal, use of a bladder catheter, CVC insertion, and intra-hospital transport were the main risk factors associated with pain-related discomfort scores.

CONCLUSION:

Patients who underwent chest drain removal, bladder catheter, CVC insertion, and intra-hospital transport during their ICU stay reported higher pain-related discomfort scores (with respect to the whole ICU stay and assessed at the end of their ICU stay) than patients who did not experience these events. This study may pave the way for further targeted studies aiming at investigating a causal link between these common procedures in the ICU and adult critically ill patients' perceptions of their ICU stay regarding recalled pain. TRIAL REGISTRATION Clinicaltrials.gov Identifier NCT02442934, retrospectively registered on May 13, 2015.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor / Qualidade de Vida / Autorrelato / Manejo da Dor Tipo de estudo: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Crit Care Ano de publicação: 2020 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor / Qualidade de Vida / Autorrelato / Manejo da Dor Tipo de estudo: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Crit Care Ano de publicação: 2020 Tipo de documento: Article País de afiliação: França