术后返回ICU患者亚急性和慢性疼痛发生率及影响因素分析

道日敖; 田园; 陈焕; 张越伦; 于春华

doi:10.12290/xhyxzz.2023-0580

术后返回ICU患者亚急性和慢性疼痛发生率及影响因素分析

Incidence and Influencing Factors of Subacute and Chronic Pain in Patients Returning to ICU After Surgery

摘要

摘要:
目的分析术后返回ICU的患者亚急性和慢性疼痛发生率及影响因素，为临床评估及管理该类患者提供诊疗思路。
方法前瞻性选择2021年11月29日—2021年12月31日在北京协和医院接受手术治疗后返回ICU的患者。在其出院1个月和3个月后进行电话随访，评估亚急性和慢性疼痛发生率及特征，并进一步分析影响因素。
结果共纳入术后返回ICU患者117例，平均年龄(60.9±16.0)岁，亚急性疼痛发生率为45.7%(53/116)，慢性疼痛发生率为32.7%(36/110)。术后中重度亚急性疼痛和慢性疼痛数字评价量表均值分别为4.9±1.2和5.2±1.1。多因素Logistic回归分析显示，合并冠心病(OR=5.263，95% CI：1.436~19.292)是术后返回ICU患者慢性疼痛的危险因素。
结论术后返回ICU患者的术后亚急性和慢性疼痛发生率较高，合并冠心病是慢性疼痛的危险因素。围术期采用多模式疼痛管理可改善患者ICU住院期间疼痛体验以及患者短期和长期预后。

Abstract:
Objective To explore the incidence and influencing factors of subacute and chronic pain in patients returning to the ICU after surgery, provide diagnostic and therapeutic insights for the evaluation and management of such patients, and improve the prognosis of this population.
Methods Patients who underwent surgical treatment and returned to the ICU from November 29, 2021 to December 31, 2021 at Peking Union Medical College Hospital were prospectively recruited. Subacute and chronic pain incidence and characteristics were assessed by telephone at 1 and 3 months after surgery and the influencing factors were further explored.
Results A total of 117 patients were enrolled, with an average age of 60.9±16.0 years. The incidence of subacute postoperative pain in patients returning to the ICU after surgery was 45.7%(53/116), and the incidence of chronic postoperative pain in patients returning to the ICU after surgery was 32.7%(36/110). The mean NRS for moderate to severe subacute pain and chronic pain after surgery were(4.9±1.2) and (5.2±1.1), respectively. Multivariable logistic regression analysis showed that coronary artery disease (OR=5.263, 95% CI: 1.436-19.292)was risk factor for chronic postoperative pain in patients returning to the ICU after surgery.
Conclusions Patients returning to the ICU after surgery have a high incidence of postoperative subacute and chronic pain. Coronary artery disease was the risk factor for chronic pain.Perioperative multimodal pain management can be used to improve the pain experience of patients during ICU hospitalization and the short-term and long-term prognosis of patients.

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