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. 2020 Jul:2020:4534-4538.
doi: 10.1109/EMBC44109.2020.9176453.

Joint Distribution and Transitions of Pain and Activity in Critically Ill Patients

Florenc Demrozi, Graziano Pravadelli, Patrick J Tighe, Azra Bihorac, Parisa Rashidi

Joint Distribution and Transitions of Pain and Activity in Critically Ill Patients

Florenc Demrozi et al. Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul.

Abstract

Pain and physical function are both essential indices of recovery in critically ill patients in the Intensive Care Units (ICU). Simultaneous monitoring of pain intensity and patient activity can be important for determining which analgesic interventions can optimize mobility and function, while minimizing opioid harm. Nonetheless, so far, our knowledge of the relation between pain and activity has been limited to manual and sporadic activity assessments. In recent years, wearable devices equipped with 3-axis accelerometers have been used in many domains to provide a continuous and automated measure of mobility and physical activity. In this study, we collected activity intensity data from 57 ICU patients, using the Actigraph GT3X device. We also collected relevant clinical information, including nurse assessments of pain intensity, recorded every 1-4 hours. Our results show the joint distribution and state transition of joint activity and pain states in critically ill patients.

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Figures

Fig. 1.
Fig. 1.
Example State Distribution Matrix (SDM) shows the relative distribution of 〈Pain, Activity〉 states.
Fig. 2.
Fig. 2.
Example State Transition Matrix (STM) shows the relative probability of transition from state 〈Pi, Aj〉 to state 〈Pk, Al〉.
Fig. 3.
Fig. 3.
Results for all patients without stratification, SDM and STM on two levels of pain and activity.
Fig. 4.
Fig. 4.
Results for all patients without stratification, SDM and STM on three levels of pain and two levels of activity.
Fig. 5.
Fig. 5.
SDM and STM on two levels of pain and activity differentiating by gender, 21 female patients.
Fig. 6.
Fig. 6.
SDM and STM on two levels of pain and activity differentiating by gender, 36 male patients.
Fig. 7.
Fig. 7.
Results obtained differentiating by outcome, 24 subjects discharged to home care.
Fig. 8.
Fig. 8.
Results obtained differentiating by outcome, 33 subjects who continued hospital treatments.
Fig. 9.
Fig. 9.
Results obtained differentiating by age, 21 patients older than 63 years.
Fig. 10.
Fig. 10.
Results obtained differentiating by age, 36 patients younger than 63 years.
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