Prevalence of chronic pain and its risk factors until one year after intensive care unit discharge. A single-center prospective observational study

Purpose

To investigate the prevalence and risk factors for long-term pain following an ICU stay.

Materials and methods

This prospective, single-center study included patients who stayed in the ICU for ≥3 days and could complete a questionnaire. The primary aim was to assess chronic pain incidence at 3 months and up to 1 year post-discharge and identify associated risk factors. Follow-up involved 3 phone interviews at 3, 6, and 12 months, utilizing the Brief Pain Inventory (BPI) and the Patient Health Questionnaire-2 (PHQ-2).

Results

Among the 150 included patients (mean age 66 ± 17 years; 66 % male; median SAPS II 39), 71(47 %) reported pain at discharge. At 3 months, 39 % of 114 respondents had pain, and 35 % of 103 patients at one year. Significant factors for pain at 3 months included urgent surgical admission (p = 0.029), axial-skeleton bone fractures (p = 0.035), days with significant pain in ICU (p = 0.004), and opioid exposure (p = 0.014 for duration, p = 0.038 for dose). Axial skeleton fractures were independently associated with pain at 1 year (OR 5.18, p = 0.023).

Conclusions

Around one-third of ICU patients experience pain one year post-discharge, with axial-skeleton bone fractures being a significant risk factor for chronic pain.

Implications for clinical practice

Management of pain and optimal opioids dose during ICU stay are crucial to limit chronic pain after ICU discharge. Special attention should be given to patients with axial-skeleton fracture.