Chaabouni Malek, Feki Walid, Moussa Nadia, Bahloul Najla, Kammoun Samy
Department of Pulmonology, Hedi Chaker Hospital, Sfax, Tunisia.
Tanaffos. 2022 Feb;21(2):167-178.
Many individuals with chronic obstructive pulmonary disease (COPD) report suffering from chronic pain, which affects their quality of life. This study aimed to determine the prevalence, characteristics and impact of chronic pain in patients with COPD, and to explore its possible predictive and aggravating factors.
It was a cross-sectional study. Male individuals with COPD responded to a questionnaire, including mMRC, CAT, Brief Pain Inventory (BPI) (composed of Worst pain, Pain Severity Score (PSS) and Pain Interference Score (PIS)), and Hospital Anxiety and Depression Scale. Patients were divided into group 1 (G1) with chronic pain, and group 2 (G2) without chronic pain.
Sixty eight patients were included. The general prevalence of chronic pain was 72.1% (CI95%:10.7%). The most common site of pain was the chest (54.4%). Analgesics were used in 38.8%. Patients from G1 had more hospital admissions in the past (OR=6.4[1.7-23.4]). Three variables were associated to pain in the multivariate analysis: socio-economic level (OR=4.6[1.1-19.2]), hospital admissions (OR=0.087[0.017-0.45]), and CAT (OR=0.18[0.05-0.72]). Dyspnea was associated to PIS (p<0.005). A correlation was found between PSS and PIS (r=0.73). Six patients (8.8%) retired because of pain. Patients who had CAT≥10 were more in G1 (OR=4.9[1.6-15.7]). CAT was correlated to PIS (r=0.5). G1 demonstrated higher anxiety scores (p<0.05). There was a moderate positive correlation between depression symptoms and PIS (r=0.33).
Pain should be systematically assessed in COPD patients, regarding its high prevalence. New guidelines should take into consideration pain management to ameliorate patients' quality of life.
许多慢性阻塞性肺疾病（COPD）患者报告患有慢性疼痛，这影响了他们的生活质量。本研究旨在确定COPD患者慢性疼痛的患病率、特征和影响，并探讨其可能的预测因素和加重因素。
这是一项横断面研究。患有COPD的男性个体回答了一份问卷，包括改良英国医学研究委员会（mMRC）呼吸困难量表、慢性阻塞性肺疾病评估测试（CAT）、简明疼痛问卷（BPI）（由最严重疼痛、疼痛严重程度评分（PSS）和疼痛干扰评分（PIS）组成）以及医院焦虑抑郁量表。患者被分为有慢性疼痛的第1组（G1）和无慢性疼痛的第2组（G2）。
共纳入68例患者。慢性疼痛的总体患病率为72.1%（95%置信区间：10.7%）。最常见的疼痛部位是胸部（54.4%）。38.8%的患者使用了镇痛药。G1组患者过去的住院次数更多（比值比（OR）=6.4[1.7 - 23.4]）。多因素分析中有三个变量与疼痛相关：社会经济水平（OR = 4.6[1.1 - 19.2]）、住院次数（OR = 0.087[0.017 - 0.45]）和CAT（OR = 0.18[0.05 - 0.72]）。呼吸困难与PIS相关（p < 0.005）。发现PSS与PIS之间存在相关性（r = 0.73）。6例患者（8.8%）因疼痛而退休。CAT≥10的患者在G1组中更多（OR = 4.9[1.6 - 15.7]）。CAT与PIS相关（r = 0.5）。G1组表现出更高的焦虑评分（p < 0.05）。抑郁症状与PIS之间存在中度正相关（r = 0.33）。
鉴于COPD患者中慢性疼痛的高患病率，应系统地评估疼痛。新的指南应考虑疼痛管理以改善患者的生活质量。
