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J Rehabil Med 2019; 51: 451–455 ORIGINAL REPORT CHRONIC PAIN IN INTENSIVE CARE UNIT SURVIVORS: INCIDENCE, CHARACTERISTICS AND SIDE-EFFECTS UP TO ONE-YEAR POST-DISCHARGE Helen DEVINE, MSc ¹ , Tara QUASIM, MD ¹,² , Joanne MCPEAKE, PhD ¹,² , Martin SHAW, PhD ¹ , Louise MCCALLUM, MSc 2 and Pamela MACTAVISH, MSc ¹ From the ¹ Glasgow Royal Infirmary, and ² University of Glasgow, School of Medicine, Glasgow Royal Infirmary, Glasgow, UK Background: Intensive care unit survivors expe- rience significant physical and psychological pro- blems, including chronic pain following discharge. The aim of this study was to observe the incidence, anatomical sites, intensity, and interference of chro- nic pain in intensive care unit survivors over a 1-year period. In addition, potential predictors of chronic pain were analysed. Methods: Data were collected during an intensive care unit follow-up programme as part of a quality improvement initiative. Data from the Brief Pain In- ventory and from musculoskeletal assessment were examined, alongside demographic data from the pa- tient. Data were collected from patients at baseline and at a 1-year follow-up appointment. Results: Data from 47 intensive care unit survivors were included in this study. In 66% (n  = 31) of the patients a “new” chronic pain that did not exist be- fore their stay in the intensive care, was reported. Pain intensity in this patient group was “moderate”’ and did not improve significantly over the 1-year pe- riod. Although pain interference with life decreased over the study period, it was still the most common cause of reduced enjoyment of life and reduced em- ployment at 1-year follow-up. Conclusion: Chronic pain is associated with morbidity in intensive care unit survivors. Pain interference, but not pain intensity, improved significantly in the first year after discharge. Further multi-centre research is required to elucidate the chronic pain experience. Key words: intensive care; chronic pain; post-intensive care syndrome; rehabilitation. Accepted Apr 17, 2019; Epub ahead of print Apr 29, 2019 J Rehabil Med 2019; 51: 451–455 Correspondence address: Pamela MacTavish, Critical Care Depart- ment, Glasgow Royal Infirmary, Castle Street, Glasgow, G4 OSF, UK. E-mail: [email protected] T he number of patients surviving a critical illness is increasing worldwide (1). With this increasing survivorship, there is now a focus on understanding the recovery trajectory of patients (2). Evidence has shown that almost two-thirds of intensive care unit (ICU) survi- vors will experience significant physical, psychological, cognitive and social problems in the months and years following discharge from critical care (3–5). This group of signs and symptoms are now commonly referred to as “post intensive care syndrome” (PICS) (6). LAY ABSTRACT The sickest patients in a hospital often need treatment in an intensive care unit. When these patients eventu- ally go home they often experience continuing psycho- logical and physical problems, including pain. The aim of this study was to look at how often pain occurred in this group of patients, where the pain occurred, and if the pain was interfering with patient’s lives. We studied 47 patients after discharge from hospital and found that two-thirds of them had pain that they did not have be- fore their stay in the intensive care unit. We followed up these patients over a 1-year period and found that the level of pain they experienced did not change over time. However, it did not interfere with their lives as much. Further studies are needed to find out why pain is such a major problem for intensive care unit survivors. An under-reported feature of PICS is chronic pain (7), defined as a “continuous, long-term pain of more than 12 weeks or after the time that healing would have been thought to have occurred in pain after trauma or surgery” (8). In the limited research published to date, almost three-quarters of ICU patients (73%) reported moderate or severe pain 12 months post-discharge (3). A further retrospective analysis of ICU patients estimated that the incidence of chronic pain in ICU survivors was as high as 44%, with the shoulder being the most commonly affected joint (9). A variety of risk factors for the development of chronic pain have been studied, including increasing patient age and severe sepsis (9). However, there is limited evidence about the intensity of pain and how this affects activities of daily living (ADL). Furthermore, there is a lack of evidence regarding how pain is treated pharmacologically. The aims of this study were to assess the incidence, intensity and location of chronic pain; to explore the level of its interference in daily life; and examine the drugs required for its treatment. In addition, the study explored predictors for developing chronic pain in the ICU survivor population, and the changing nature of such pain over time. MATERIAL AND METHODS Participants Patients who attended the pilot phase of an ICU recovery programme were included in this evaluation. Intensive Care Syndrome: Promoting Independence and Return to Employ- This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977 doi: 10.2340/16501977-2558