Long-term disability after blunt chest trauma: Don't miss chronic neuropathic pain!

被引:26
作者
Carrie, Cedric [1 ]
Guemmar, Yassine [1 ]
Cottenceau, Vincent [1 ]
de Molliens, Louis [1 ]
Petit, Laurent [1 ]
Sztark, Francois [1 ,2 ]
Biais, Matthieu [1 ,2 ]
机构
[1] CHU Bordeaux, Anesthesiol & Crit Care Dept, F-33000 Bordeaux, France
[2] Univ Bordeaux Segalen, F-33000 Bordeaux, France
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2019年 / 50卷 / 01期
关键词
Chest trauma; Chronic pain; Neuropathic pain; Respiratory disability; Intensive care; RIB FRACTURES; PARAVERTEBRAL BLOCK; RISK; MANAGEMENT; ADMISSION; ANALGESIA; ARDS; CARE;
D O I
10.1016/j.injury.2018.10.023
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction The main objective of this prospective study was to assess the incidence of chronic pain and long-term respiratory disability in a single-center cohort of severe blunt chest trauma patients. Methods Over a 10-month period, all consecutive blunt chest trauma patients admitted in Intensive Care Unit (ICU) were screened to participate in a 3-month and 12-month follow-up. The following variables were prospectively assessed: persistence of chronic chest pain requiring regular used of analgesics, neuropathic pain, respiratory disability, physical and mental health status. Univariate and multivariable analysis were conducted to assess variables associated with chronic chest pain, neuropathic chest pain and respiratory disability. Results During the study period, 65 patients were included in the study. Chronic chest pain and respiratory disability were reported in 62% and 57% of patients respectively at 3 months postinjury. Neuropathic pain was reported in 22% of patients, associated with higher impairment of quality of life. A thoracic trauma severity score >= 12 and a pain score >= 4 at SICU discharge were the only variables significantly associated with the occurrence of neuropathic pain at 3 months (OR = 7 [2-32], p = 0.01 and OR = 16 [4-70], p < 0.0001). Conclusion According to the current study, chronic pain and long-term respiratory disability are very common after severe blunt chest trauma patients. Special attention should be paid to neuropathic pain, frequently under-diagnosed and responsible for significant impairment of quality of life. (C) 2018 Elsevier Ltd. All rights reserved.
引用
收藏
页码:113 / 118
页数:6
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