TY - JOUR
T1 - Bodily pain in survivors of acute respiratory distress syndrome
T2 - A 1-year longitudinal follow-up study
AU - Probert, Julia M.
AU - Lin, Shihong
AU - Yan, Haijuan
AU - Leoutsakos, Jeannie Marie S.
AU - Dinglas, Victor D.
AU - Hosey, Megan M.
AU - Parker, Ann M.
AU - Hopkins, Ramona O.
AU - Needham, Dale M.
AU - Neufeld, Karin J.
N1 - Funding Information:
This research was supported by the NHLBI ( R24 HL111895 , R01HL091760 , and R01HL091760-02S1 ), the Johns Hopkins Institute for Clinical and Translational Research (ICTR) ( UL1 TR 000424-06 ), and the ALTA, EDEN, OMEGA and SAILS trials (NHLBI contracts HHSN268200536165C to HHSN268200536176C and HHSN268200536179C ).
Publisher Copyright:
© 2021
PY - 2021/5
Y1 - 2021/5
N2 - Purpose: Acute respiratory distress syndrome (ARDS) survivors frequently experience bodily pain during recovery after the intensive care unit. Longitudinal course, risk factors and associations with physical and neuropsychological health is lacking. Methods: We collected self-reported pain using the Short Form-36 Bodily Pain (SF-36 BP) scale, normalized for sex and age (range: 0–100; higher score = less pain), along with physical and mental health measures in a multi-center, prospective cohort of 826 ARDS survivors at 6- and 12-month follow-up. We examined baseline and ICU variables' associations with pain via separate unadjusted regression models. Results: Pain prevalence (SF-36 BP ≤40) was 45% and 42% at 6 and 12 months, respectively. Among 706 patients with both 6- and 12-month data, 34% reported pain at both timepoints. Pre-ARDS employment was associated with less pain at 6-months (mean difference (standard error), 5.7 (0.9), p < 0.001) and 12-months (6.3 (0.9), p < 0.001); smoking history was associated with greater pain (−5.0 (0.9), p < 0.001, and − 5.4 (1.0), p < 0.001, respectively). In-ICU opioid use was associated with greater pain (−6.3 (2.7), p = 0.02, and − 7.3 (2.8), p = 0.01, respectively). At 6 months, 174 (22%) patients reported co-occurring pain, depression and anxiety, and 227 (33%) reported co-occurring pain and impaired physical function. Conclusion: Nearly half of ARDS survivors reported bodily pain at 6- and 12-month follow-up; one-third reported pain at both time points. Pre-ARDS unemployment, smoking history, and in-ICU opioid use may identify patients who report greater pain during recovery. Given its frequent co-occurrence, clinicians should manage both physical and neuropsychological issues when pain is reported.
AB - Purpose: Acute respiratory distress syndrome (ARDS) survivors frequently experience bodily pain during recovery after the intensive care unit. Longitudinal course, risk factors and associations with physical and neuropsychological health is lacking. Methods: We collected self-reported pain using the Short Form-36 Bodily Pain (SF-36 BP) scale, normalized for sex and age (range: 0–100; higher score = less pain), along with physical and mental health measures in a multi-center, prospective cohort of 826 ARDS survivors at 6- and 12-month follow-up. We examined baseline and ICU variables' associations with pain via separate unadjusted regression models. Results: Pain prevalence (SF-36 BP ≤40) was 45% and 42% at 6 and 12 months, respectively. Among 706 patients with both 6- and 12-month data, 34% reported pain at both timepoints. Pre-ARDS employment was associated with less pain at 6-months (mean difference (standard error), 5.7 (0.9), p < 0.001) and 12-months (6.3 (0.9), p < 0.001); smoking history was associated with greater pain (−5.0 (0.9), p < 0.001, and − 5.4 (1.0), p < 0.001, respectively). In-ICU opioid use was associated with greater pain (−6.3 (2.7), p = 0.02, and − 7.3 (2.8), p = 0.01, respectively). At 6 months, 174 (22%) patients reported co-occurring pain, depression and anxiety, and 227 (33%) reported co-occurring pain and impaired physical function. Conclusion: Nearly half of ARDS survivors reported bodily pain at 6- and 12-month follow-up; one-third reported pain at both time points. Pre-ARDS unemployment, smoking history, and in-ICU opioid use may identify patients who report greater pain during recovery. Given its frequent co-occurrence, clinicians should manage both physical and neuropsychological issues when pain is reported.
KW - ARDS
KW - Anxiety
KW - Critical illness survival
KW - Depression
KW - Pain
KW - Physical function
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U2 - 10.1016/j.jpsychores.2021.110418
DO - 10.1016/j.jpsychores.2021.110418
M3 - Article
C2 - 33744745
AN - SCOPUS:85103122838
VL - 144
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
SN - 0022-3999
M1 - 110418
ER -