Peri Francesca, Magni Elena, Pigani Filippo, Romoli Raffaella, Vetrella Simona, De Zen Lucia, Sagredini Raffaella, Barbi Egidio, Cozzi Giorgio
Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.
Department of Pediatrics, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
Front Pediatr. 2024 Mar 6;12:1365152. doi: 10.3389/fped.2024.1365152. eCollection 2024.
Pain's causes in children with severe cognitive impairment may be challenging to diagnose. This study aimed to investigate if there is a relationship between pain causes and the age of children.
We conducted a multicenter retrospective study in three Italian Pediatric Units. Eligible subjects were patients from 1 to 18 years with severe neurological impairment. We collected data regarding diagnoses, pain causes and medical or surgical procedures. The timing of pain episodes was categorized into age-related periods: infants and toddlers (0-24 months), preschool children (3-5 years), schoolchildren (6-12 years), and adolescents (13-17 years).
Eighty children with severe neurological impairment were enrolled. The mean age was 11 years (±5.8). Gastroenterological pain was most common in the first years of life ( = 0.004), while orthopaedic and tooth pain was the most typical in schoolchildren and adolescents ( = 0.001 and = 0.02). Concerning surgical procedures, PEG placement and gastric fundoplication were significantly more common in the first 5 years of age ( = 0.03), and heart surgery was typical of infants ( = 0.04). Orthopaedic surgery was more commonly reported in older children and adolescents ( < 0.001).
Some causes of pain are more frequent in children with severe neurological impairment in defined age-related periods. Specific age-related pain frequencies may help physicians in the diagnostic approach.
诊断重度认知障碍儿童的疼痛原因可能具有挑战性。本研究旨在调查疼痛原因与儿童年龄之间是否存在关联。
我们在意大利的三个儿科单位进行了一项多中心回顾性研究。符合条件的受试者为1至18岁患有严重神经功能障碍的患者。我们收集了有关诊断、疼痛原因以及医疗或外科手术的资料。疼痛发作的时间被分为与年龄相关的阶段：婴幼儿（0 - 24个月）、学龄前儿童（3 - 5岁）、学龄儿童（6 - 12岁）和青少年（13 - 17岁）。
纳入了80名患有严重神经功能障碍的儿童。平均年龄为11岁（±5.8）。胃肠疼痛在生命的最初几年最为常见（= 0.004），而骨科和牙齿疼痛在学龄儿童和青少年中最为典型（= 0.001和 = 0.02）。关于外科手术，胃造口术和胃底折叠术在5岁前明显更为常见（= 0.03），心脏手术在婴儿中较为典型（= 0.04）。骨科手术在年龄较大的儿童和青少年中报告更为常见（< 0.001）。
在特定的与年龄相关的阶段，重度神经功能障碍儿童中某些疼痛原因更为常见。特定的与年龄相关的疼痛频率可能有助于医生进行诊断。
