Chronic pain in in survivors of critical illness: prevalence and associated psychological disorders.

Aim: To investigate the prevalence and characteristics of chronic postICU pain in survivors of critical illness and to examine the association between pain and psychological disorders.

Methods: The study was carried out in an Italian ICU. Six months after ICU discharge, patients were called back for an interview for assessed chronic pain (CP), pain intensity, pain location and interference of pain with activities of daily living. During the interview a battery of psychometric test was administered for evaluate anxiety, depression, insomnia, fatigue and posttraumatic stress disorder (PTSD).

Results: A total of 143 patients were interviewed and 34 patients (23.8%) reported pain. Nearly 70.6% of respondents suffering from CP were females (p<.001). The most common sites of pain were the shoulder (16.1%), lower limb (11.9%) and the lumbar spine (11.2%). The largest number of CP patients (n= 14) had pain at 4 or more anatomical regions. The prevalence for chronic pain, anxiety, depression, insomnia, fatigue and PTSD were 23.8%, 9.1%, 13.3%, 4.2%, 5.6% and 2.1% respectively. The multivariable analysis indicated significant associations between chronic pain and anxiety (p= .003), depression (p=.015) and insomnia (p= .027). There was a great use of analgesics and nonsteroidal antiinflammatory drugs (NSAIDs) for the pain treatment in 19 patients (55.9%).

Discussion: Cronic pain seems associated with some psychological disorders observed 6 months after an ICU stay. In future, studies that investigate interventions to prevent chronic postICU pain are needed.