Giannelou Evangelia, Papathanassoglou Elizabeth, Karanikola Maria, Giannakopoulou Margarita, Bozas Evangelos, Skopeliti Niki, Mpouzika Meropi
Department of Nursing, Cyprus University of Technology, Limassol, Cyprus; Intensive Care Unit, General Athens Hospital 'Georgios Gennimatas', Athens, Greece; Department of Haematology, University of Cambridge, Cambridge, UK.
Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
Intensive Crit Care Nurs. 2025 Jun;88:104003. doi: 10.1016/j.iccn.2025.104003. Epub 2025 Mar 21.
To identify patient characteristics and clinical factors during ICU hospitalization potentially associated with chronic pain occurrence, and to determine its relationship with symptoms of post-traumatic stress disorder (PTSD) and health-related quality of life (HRQoL) at three time points after ICU discharge.
Adult ICU survivors were enrolled in a prospective, repeated measures study. The study was carried out in two phases. Phase I was conducted during the first 5 days of survivors' ICU hospitalization where patient characteristics and clinical data were collected. Phase II was conducted via telephone interviews after 3 (T1), 6 (T2) and 12 (T3) months post-ICU discharge, where pain, PTSD-related symptoms, and HRQoL were assessed with the Numeric Rating Scale (NRS), Davidson Trauma Scale (DTS), and 36-Item Short Form Survey version 2 (SF-36v2), respectively.
Data from 59 survivors were analysed, 69.5% of whom were males. The sample's mean age was 52.7 (SD 18.9) years and 62.7% of them reported NRS>3 at T1, indicating chronic pain. After adjusting for sex, age, and APACHE II score, chronic pain was significantly associated with: (a) length of stay in the ICU (OR=1.42; 95%CI: 1.03-1.95; p=0.030) and (b) clinically relevant symptoms of PTSD at T1 (OR=10.04; 95%CI: 2.44-41.24; p=0.001) and T2 (OR=11.90; 95%CI: 1.28-110.49; p=0.029). Lower SF-36v2 scores in all domains at T1, several domains at T2, and two domains at T3 were significantly associated with CP occurrence.
Of the patient characteristics and clinical factors analysed, only longer length of stay in ICU was significantly associated with higher odds of chronic pain occurrence, which in turn was linked to PTSD-related symptoms and lower HRQoL after ICU discharge.
Clinical interventions aimed at optimizing ICU length of stay, such as the implementation of early mobility programs and multidisciplinary rehabilitation, may support prevention of chronic pain occurrence and improve long-term outcomes.
确定重症监护病房（ICU）住院期间可能与慢性疼痛发生相关的患者特征和临床因素，并确定其与ICU出院后三个时间点的创伤后应激障碍（PTSD）症状及健康相关生活质量（HRQoL）的关系。
成年ICU幸存者被纳入一项前瞻性重复测量研究。该研究分两个阶段进行。第一阶段在幸存者ICU住院的前5天进行，收集患者特征和临床数据。第二阶段在ICU出院后3个月（T1）、6个月（T2）和12个月（T3）通过电话访谈进行，分别使用数字评定量表（NRS）、戴维森创伤量表（DTS）和简明健康调查量表第2版（SF - 36v2）评估疼痛、PTSD相关症状和HRQoL。
分析了59名幸存者的数据，其中69.5%为男性。样本的平均年龄为52.7（标准差18.9）岁，62.7%的患者在T1时NRS>3，表明存在慢性疼痛。在调整性别、年龄和急性生理与慢性健康状况评分系统II（APACHE II）评分后，慢性疼痛与以下因素显著相关：（a）ICU住院时间（比值比[OR]=1.42；95%置信区间[CI]：1.03 - 1.95；p = 0.030）；（b）T1（OR = 10.04；95%CI：2.44 - 41.24；p = 0.001）和T2（OR = 11.90；95%CI：1.28 - 110.49；p = 0.029）时PTSD的临床相关症状。T1时所有领域、T2时几个领域以及T3时两个领域的较低SF - 36v2评分与慢性疼痛的发生显著相关。
在所分析的患者特征和临床因素中，只有较长的ICU住院时间与慢性疼痛发生的较高几率显著相关，而慢性疼痛又与PTSD相关症状及ICU出院后的较低HRQoL相关。
旨在优化ICU住院时间的临床干预措施，如实施早期活动计划和多学科康复，可能有助于预防慢性疼痛的发生并改善长期预后。
