Risk factors and events in the adult intensive care unit associated with pain as self-reported at the end of the intensive care unit stay.
Aged
Aged, 80 and over
Cluster Analysis
Critical Illness
/ therapy
Female
France
Humans
Intensive Care Units
/ organization & administration
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Multivariate Analysis
Pain
/ complications
Pain Management
/ methods
Pain Measurement
/ methods
Quality of Life
/ psychology
Risk Factors
Self Report
/ statistics & numerical data
Statistics, Nonparametric
Surveys and Questionnaires
Chest drain
Critical care
Discomfort
IPREA
Intensive care unit
Intra-hospital transport
Pain
Patient-reported outcome
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
07 12 2020
07 12 2020
Historique:
received:
19
08
2020
accepted:
18
11
2020
entrez:
8
12
2020
pubmed:
9
12
2020
medline:
28
7
2021
Statut:
epublish
Résumé
The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically ill patients during the whole ICU stay as self-reported by patients at the end of their ICU stay. The study involved 34 ICUs. Adult patients who survived an ICU stay of 3 calendar days or more were eligible for inclusion. Discomforts, including the pain-related discomfort, were assessed using the French 18-item questionnaire on discomfort in ICU patients, the "Inconforts des Patients de REAnimation" (IPREA). Patients scored each item from 0 (minimal discomfort) to 10 (maximal discomfort). Associations between patient characteristics at ICU admission, life support therapies and main potentially painful procedures performed during the ICU stay and pain-related discomfort scores assessed at the end of the ICU stay were analyzed. Patients with complete IPREA questionnaires (n = 2130) were included. The median pain-related discomfort score was 3 (IQR 0-5). From the univariate analysis, pain-related discomfort scores were negatively correlated with age and positively correlated with ICU stay duration; surgical patients reported significant higher pain-related discomfort scores than medical patients; chest drain insertion, chest drain removal, use of bladder catheter, central venous catheter (CVC) insertion, complex dressing change, and intra-hospital transport were associated with pain-related discomfort scores. From the multivariate analyses using generalized estimating equations models, only age, chest drain removal, use of a bladder catheter, CVC insertion, and intra-hospital transport were the main risk factors associated with pain-related discomfort scores. Patients who underwent chest drain removal, bladder catheter, CVC insertion, and intra-hospital transport during their ICU stay reported higher pain-related discomfort scores (with respect to the whole ICU stay and assessed at the end of their ICU stay) than patients who did not experience these events. This study may pave the way for further targeted studies aiming at investigating a causal link between these common procedures in the ICU and adult critically ill patients' perceptions of their ICU stay regarding recalled pain. Clinicaltrials.gov Identifier NCT02442934, retrospectively registered on May 13, 2015.
Sections du résumé
BACKGROUND
The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically ill patients during the whole ICU stay as self-reported by patients at the end of their ICU stay.
METHODS
The study involved 34 ICUs. Adult patients who survived an ICU stay of 3 calendar days or more were eligible for inclusion. Discomforts, including the pain-related discomfort, were assessed using the French 18-item questionnaire on discomfort in ICU patients, the "Inconforts des Patients de REAnimation" (IPREA). Patients scored each item from 0 (minimal discomfort) to 10 (maximal discomfort). Associations between patient characteristics at ICU admission, life support therapies and main potentially painful procedures performed during the ICU stay and pain-related discomfort scores assessed at the end of the ICU stay were analyzed.
RESULTS
Patients with complete IPREA questionnaires (n = 2130) were included. The median pain-related discomfort score was 3 (IQR 0-5). From the univariate analysis, pain-related discomfort scores were negatively correlated with age and positively correlated with ICU stay duration; surgical patients reported significant higher pain-related discomfort scores than medical patients; chest drain insertion, chest drain removal, use of bladder catheter, central venous catheter (CVC) insertion, complex dressing change, and intra-hospital transport were associated with pain-related discomfort scores. From the multivariate analyses using generalized estimating equations models, only age, chest drain removal, use of a bladder catheter, CVC insertion, and intra-hospital transport were the main risk factors associated with pain-related discomfort scores.
CONCLUSION
Patients who underwent chest drain removal, bladder catheter, CVC insertion, and intra-hospital transport during their ICU stay reported higher pain-related discomfort scores (with respect to the whole ICU stay and assessed at the end of their ICU stay) than patients who did not experience these events. This study may pave the way for further targeted studies aiming at investigating a causal link between these common procedures in the ICU and adult critically ill patients' perceptions of their ICU stay regarding recalled pain.
TRIAL REGISTRATION
Clinicaltrials.gov Identifier NCT02442934, retrospectively registered on May 13, 2015.
Identifiants
pubmed: 33287910
doi: 10.1186/s13054-020-03396-2
pii: 10.1186/s13054-020-03396-2
pmc: PMC7722444
doi:
Banques de données
ClinicalTrials.gov
['NCT02442934']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
685Subventions
Organisme : French Ministry of Health (Programme Hospitalier de Recherche Clinique National, 2012)
ID : 12-010-0554
Pays : International
Investigateurs
Karine Vie
(K)
Gwenaëlle Lannuzel
(G)
Hélène Bout
(H)
Jean-Philippe Parthiot
(JP)
Isabelle Chazal
(I)
Philippe Charve
(P)
Caroline Prum
(C)
Jean-Pierre Quenot
(JP)
Nora Perrot
(N)
Francis Augier
(F)
Niloufar Behechti
(N)
Claudine Cocusse
(C)
Céline Foulon
(C)
Laurence Goncalves
(L)
Abdesselem Hanchi
(A)
Etienne Legros
(E)
Ana Isabel Mercier
(AI)
Nicolas Meunier-Beillard
(N)
Nathalie Nuzillat
(N)
Alicia Richard
(A)
Claire Boulle
(C)
Benjamin Kowalski
(B)
Elisa Klusek
(E)
Tarek Sharshar
(T)
Andrea Polito
(A)
Caroline Duvallet
(C)
Sonia Krim
(S)
Nicolas Girard
(N)
Cécile Jourdain
(C)
Stéphane Techer
(S)
Corinne Chauvel
(C)
Corinne Bruchet
(C)
Johanna Temime
(J)
Stéphanie Beaussart
(S)
Fabienne Jarosz
(F)
Jullien Crozon-Clauzel
(J)
Serge Olousouzian
(S)
Sylvie Pereira
(S)
Loïc Argentin
(L)
Valérie Cerro
(V)
Déborah Levy
(D)
Sébastien Andre
(S)
Christophe Guervilly
(C)
Laurent Papazian
(L)
Myriam Moussa
(M)
Stéphanie Renoult
(S)
Delphine Biet
(D)
Steve Novak
(S)
Jean-Christophe Orban
(JC)
Aminata Diop
(A)
Carole Ichai
(C)
Antoine Tesniere
(A)
Jean-Pascal Goupil
(JP)
Frédérique Laville
(F)
Nadège Rutter
(N)
Sandie Brochon
(S)
Kelly Tiercelet
(K)
Julien Amour
(J)
Nora Ait-Hamou
(N)
Marjorie Leger
(M)
Virginie Souppart
(V)
Emilie Griffault
(E)
Marie-Line Debarre
(ML)
Céline Deletage
(C)
Anne-Laure Guerin
(AL)
Carole Guignon
(C)
Sabrina Seguin
(S)
Christophe Hart
(C)
Kathy Dernivoix
(K)
Caroline Wuiot
(C)
Karine Sanches
(K)
Stéphane Hecketsweiler
(S)
Catherine Sylvestre-Marconville
(C)
Vincent Gardan
(V)
Stéphanie Deparis-Dusautois
(S)
Yana Chaban
(Y)
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