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 - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Critical Care Année : 2020

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

Georges Simon
  • Fonction : Auteur
Julien Pottecher

Résumé

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
Fichier principal
Vignette du fichier
13054_2020_Article_3396.pdf (891.39 Ko) Télécharger le fichier
Origine Fichiers éditeurs autorisés sur une archive ouverte
Licence

Dates et versions

hal-03440855 , version 1 (24-10-2023)

Licence

Identifiants

Citer

Pierre Kalfon, Mohamed Boucekine, Philippe Estagnasie, Marie-Agnès Geantot, Audrey Berric, et al.. 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. Critical Care, 2020, 24 (1), ⟨10.1186/s13054-020-03396-2⟩. ⟨hal-03440855⟩
48 Consultations
20 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More