Institute for Stroke and Cerebrovascular Disease and Cizik School of Nursing, University of Texas Health Science Center at Houston, United States; Institute for Stroke and Cerebrovascular Disease, University of Texas Health Science Center at Houston, United States.
Institute for Stroke and Cerebrovascular Disease, University of Texas Health Science Center at Houston, United States.
J Stroke Cerebrovasc Dis. 2023 Dec;32(12):107370. doi: 10.1016/j.jstrokecerebrovasdis.2023.107370. Epub 2023 Oct 11.
Pain is an overlooked sequela of stroke. Persistent pain after stroke is an underrecognized experience and significantly impacts survivors' function, ability to participate in rehabilitation, and quality of life. The aim of this retrospective, observational study is to examine the incidence of pain at the acute hospitalization period immediately after stroke, to identify the characteristics of those reporting pain at discharge, and to compare pain reporting between stroke and non-stroke hospital controls.
Using discharge diagnosis, this retrospective review examined self- reports of pain during acute hospitalization for stroke compared to those with COPD (control group) admitted during the same time in the same facilities. Variables of interest included age, gender, body mass index (BMI), length of stay, pain assessment score (numeric rating scale [NRS], behavior pain scale [BPS], and medication administration record pain score total [MAR]), smoking history, prevalence of hypertension and race. 821 subjects were included from a total of three campuses from one large hospital system. 772 subjects were included in the comparative analysis with COPD patients from the same facilities during the same time.
43% of patients diagnosed with stroke reported pain at discharge. For stroke survivors reporting pain at discharge, the average BMI was higher (p=0.009), average arrival NIHSS was higher (p=0.044), and mean hospital length of stay was longer (p<0.001).
The evidence demonstrated in this study highlights the critical need for the implementation of targeted objective pain assessment and effective pain interventions for stroke survivors beginning at initial hospitalization.
疼痛是中风的一种被忽视的后遗症。中风后持续疼痛是一种未被充分认识的体验，会严重影响幸存者的功能、康复能力和生活质量。本回顾性观察研究的目的是检查中风患者在急性住院期间即刻发生疼痛的发生率，确定出院时报告疼痛的患者的特征，并比较中风患者和非中风医院对照者的疼痛报告情况。
使用出院诊断，本回顾性研究检查了急性住院期间中风患者的自我报告疼痛情况，并与同期同一设施中患有 COPD（对照组）的患者进行了比较。感兴趣的变量包括年龄、性别、体重指数（BMI）、住院时间、疼痛评估评分（数字评分量表[NRS]、行为疼痛量表[BPS]和药物管理记录疼痛评分总和[MAR]）、吸烟史、高血压患病率和种族。从一个大型医院系统的三个校区共纳入 821 名患者。共有 772 名患者被纳入与同期同一设施中的 COPD 患者进行的比较分析。
43%被诊断为中风的患者在出院时报告有疼痛。对于出院时报告有疼痛的中风幸存者，平均 BMI 更高（p=0.009），平均入院 NIHSS 更高（p=0.044），平均住院时间更长（p<0.001）。
本研究中的证据强调了在初始住院时开始为中风幸存者实施有针对性的客观疼痛评估和有效的疼痛干预措施的迫切需要。
