Incidence and Influencing Factors of Pain Crisis in Cancer Patients: A Systematic Review and Meta-Analysis

Abstract

Aims

To systematically evaluate the incidence and influencing factors of pain crisis in cancer patients, providing evidence for targeted preventive interventions and optimized clinical nursing strategies.

Design

A systematic review and meta-analysis following PRISMA guidelines.

Data Sources

PubMed, Cochrane Library, Web of Science, CINAHL, Embase, SinoMed, CNKI, Wanfang, and VIP were searched from inception to February 2026.

Review Methods

Literature screening, quality assessment, and data extraction were performed independently by two researchers. Meta-analysis was conducted using RevMan 5.4. Heterogeneity was assessed using the I² statistic, and effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).

Results

Seven studies involving 1865 cancer patients were included. The pooled incidence of pain crisis was 37%. Significant influencing factors included bone metastasis (OR = 3.91), radiotherapy and chemotherapy (OR = 3.23), social support (OR = 0.88), and age (OR = 0.92). Anxiety (mild OR = 8.00, moderate OR = 9.15, severe OR = 10.99) and depression (mild OR = 6.54, moderate OR = 6.46) were also significant predictors.

Conclusions

The incidence of pain crisis in cancer patients is relatively high and is influenced by bone metastasis, chemoradiotherapy, social support, age, and emotional states. Nurses should dynamically assess risk, identify factors, and implement individualized interventions to prevent pain crisis and improve quality of life.

Impact

This meta-analysis provides robust evidence for identifying high-risk cancer patients for pain crisis. The findings underscore the need for integrating routine psychological assessment and tailored pain management strategies into clinical oncology nursing practice to reduce the occurrence of pain crises and enhance patient well-being.

Patient or Public Contribution

Not applicable.