入住重症监护室后的疼痛和心理病理学。

IF 1.1 4区 医学 Q3 ANESTHESIOLOGY
Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI:10.1177/0310057X241226716
Nour Smaisim, Mienke Rijsdijk, Yuri van der Does, Arjen Jc Slooter
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引用次数: 0

摘要

在入住重症监护病房(ICU)1 年后,分别有 18% 和 55% 的患者出现疼痛和精神病理现象。众所周知,在普通人群中,慢性疼痛和精神病理学具有双向关系,但对于重症监护病房的幸存者来说,这种关系是否成立还不得而知。本研究的目的是调查入住 ICU 之前、期间和之后的疼痛是否与 ICU 存活者出院 1 年后的精神病理学有关。我们于 2013 年至 2016 年期间在荷兰的一家混合重症监护病房进行了一项队列研究。在1年的随访中,患者完成了医院焦虑和抑郁量表、事件影响量表/事件影响量表-修订版,并回答了有关疼痛的标准化问题。心理病理学被定义为焦虑、抑郁和/或创伤后应激障碍症状。我们使用多变量逻辑回归分析来评估入院前、入院期间和入院后的疼痛与随访 1 年的精神病理学之间的关系。我们共纳入了 1105 名患者,其中 558 人(50%)(95% 置信区间 (CI):0.48 至 0.54)在随访 1 年时有精神病理学症状。入住 ICU 前的疼痛(几率比 (OR) 1.18;95% CI 1.10 至 1.26)和入住 ICU 后的疼痛(OR 2.38;95% CI 1.68 至 3.35)与精神病理学有关。入住重症监护室期间的疼痛与精神病理学无关,但入住重症监护室期间疼痛治疗不足的记忆与精神病理学有关(OR 2.19;95% CI 1.39 至 3.45)。因此,关注与入住重症监护室有关的疼痛和疼痛治疗经历可能有助于及早识别有心理病理学发展风险的重症监护室幸存者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pain and psychopathology after intensive care unit admission.

Pain and psychopathology are observed in 18% and 55% of patients, respectively, 1 year after intensive care unit (ICU) admission. It is well known that chronic pain and psychopathology have a bidirectional relation in the general population, but it is not known whether this holds true for ICU survivors. The aim of this study was to investigate whether pain before, during and after ICU admission is related to psychopathology in ICU survivors 1 year after discharge. We performed a cohort study in a mixed ICU in the Netherlands between 2013 and 2016. At 1-year follow-up, patients completed the Hospital Anxiety and Depression Scale, the Impact of Event Scale/Impact of Event Scale-Revised, and answered standardised questions regarding pain. Psychopathology was defined as having anxiety, depressive and/or post-traumatic stress disorder symptoms. We used multivariable logistic regression analysis to evaluate the association of pain before, during and after ICU admission with psychopathology at 1 year follow-up. We included 1105 patients of whom 558 (50%) (95% confidence interval (CI) 0.48 to 0.54) had psychopathology at 1 year follow-up. Pain before ICU admission (odds ratio (OR) 1.18; 95% CI 1.10 to 1.26) and pain after ICU admission (OR 2.38; 95% CI 1.68 to 3.35) were associated with psychopathology. Pain during ICU stay was not associated with psychopathology, but the memory of insufficient pain management during ICU stay was (OR 2.19; 95% CI 1.39 to 3.45). Paying attention to pain and pain treatment experiences related to ICU admission may therefore contribute to early identification of ICU survivors at risk of psychopathology development.

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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
150
审稿时长
3 months
期刊介绍: Anaesthesia and Intensive Care is an international journal publishing timely, peer reviewed articles that have educational value and scientific merit for clinicians and researchers associated with anaesthesia, intensive care medicine, and pain medicine.
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