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Multicenter Study
. 2023 May 25;27(1):199.
doi: 10.1186/s13054-023-04491-w.

Prevalence and risk factors of significant persistent pain symptoms after critical care illness: a prospective multicentric study

Alexandre Bourdiol  1 , Vincent Legros  2 , Fanny Vardon-Bounes  3 , Thomas Rimmele  4   5 , Paul Abraham  6 , Clément Hoffmann  7 , Claire Dahyot-Fizelier  8   9 , Maud Jonas  10 , Pierre Bouju  11 , Cédric Cirenei  12 , Yoann Launey  13 , Gregoire Le Gac  13   14 , Samia Boubeche  15 , Edouard Lamarche  16 , Olivier Huet  17 , Lucillia Bezu  18   19 , Julie Darrieussecq  20 , Magdalena Szczot  21 , Agathe Delbove  22 , Johan Schmitt  23 , Sigismond Lasocki  24 , Johann Auchabie  25 , Ludivine Petit  26 , Emmanuelle Kuhn-Bougouin  27 , Karim Asehnoune  1 , Hugo Ingles  1 , Antoine Roquilly  1   28 , Raphaël Cinotti  29   30   31 ; ALGO-RÉA study group; Atlanréa Group; Société Française d’Anesthésie-Réanimation–SFAR Research Network
Collaborators, Affiliations
Multicenter Study

Prevalence and risk factors of significant persistent pain symptoms after critical care illness: a prospective multicentric study

Alexandre Bourdiol et al. Crit Care. .

Abstract

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.

Keywords: Critical care; ID-pain; Neuropathic pain; Pain; Post-intensive care syndrome.

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Conflict of interest statement

Dr. Cinotti has received consulting fees for PAION outside the scope of the study. Dr. Roquilly reported receiving grants and consulting fees from Merck and bioMérieux outside the scope of the study. Dr. Asehnoune reported receiving lecture fees from Baxter, Fisher & Paykel, and LFB and consulting fees from Edwards Lifesciences and LFB, outside the scope of this study. The other authors do not have any conflict of interest to declare. No competing interest is to be declared regarding the present work.

Figures

Fig. 1
Fig. 1
Flowchart of the study
See this image and copyright information in PMC

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