Prevalence, characteristics and treatment of chronic pain in elderly patients hospitalized in internal medicine wards

被引：29

作者：

Corsi, Nicole ^{[1
]}

Roberto, Anna ^{[1
]}

Cortesi, Laura ^{[2
]}

Nobili, Alessandro ^{[2
]}

Mannucci, Pier Mannuccio ^{[3
]}

Corli, Oscar ^{[1
]}

Prisco, Domenico ^{[4
]}

Silvestri, Elena ^{[4
]}

Emmi, Giacomo ^{[4
]}

Bettiol, Alessandra ^{[4
]}

Caterina, Cenci ^{[4
]}

Biolo, Gianni ^{[5
]}

Zanetti, Michela ^{[5
]}

Guadagni, Martina ^{[5
]}

Zaccari, Michele ^{[1
,5
]}

Chiuch, Massimiliano ^{[5
]}

Zaccari, Michele ^{[1
,5
]}

Vanoli, Massimo ^{[6
]}

Grignani, Giulia ^{[6
]}

Pulixi, Edoardo Alessandro ^{[6
]}

Bernardi, Mauro ^{[7
]}

Bassi, Silvia Li ^{[7
]}

Santi, Luca ^{[7
]}

Zaccherini, Giacomo ^{[7
]}

Lupattelli, Graziana ^{[8
]}

Mannarino, Elmo ^{[8
]}

Bianconi, Vanessa ^{[8
]}

Paciullo, Francesco ^{[8
]}

Alcidi, Riccardo ^{[8
]}

Nuti, Ranuccio ^{[9
]}

Valenti, Roberto ^{[9
]}

Ruvio, Martina ^{[9
]}

Cappelli, Silvia ^{[9
]}

Palazzuoli, Alberto ^{[9
]}

Girelli, Domenico ^{[10
]}

Busti, Fabiana ^{[10
]}

Marchi, Giacomo ^{[10
]}

Barbagallo, Mario ^{[11
]}

Dominguez, Ligia ^{[11
]}

Cocita, Floriana ^{[11
]}

Beneduce, Vincenza ^{[11
]}

Plances, Lidia ^{[11
]}

Corrao, Salvatore ^{[12
]}

Natoli, Giuseppe ^{[12
]}

Mularo, Salvatore ^{[12
]}

Raspanti, Massimo ^{[12
]}

Cavallaro, Federica ^{[12
]}

Zoli, Marco ^{[13
]}

Lazzari, Ilaria ^{[13
]}

Brunori, Mattia ^{[13
]}

机构：

[1] IRCCS Mario Negri Inst Pharmacol Res, Dept Oncol, Pain & Palliat Care Res Unit, Via G La Masa 19, Milan, Italy

[2] IRCCS Mario Negri Inst Pharmacol Res, Neurosci Dept, Qual Assessment Geriatr Therapies & Serv Lab, Milan, Italy

[3] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Sci Direct, Milan, Italy

[4] Azienda Osped Univ Careggi Firenze, Med Interna Interdisciplinare, Florence, Italy

[5] Azienda Sanitaria Univ Integrata Trieste, Clin Med Gen & Terapia Med, Trieste, Italy

[6] Osped Merate, Azienda Osped Prov Lecco, Med Interna, Lecce, Italy

[7] Azienda Osped Policlin St Orsola Malpighi, Semeiot Med Bernardi, Bologna, Italy

[8] Azienda Osped Santa Maria Misericordia, Med Interna, Perugia, Italy

[9] Azienda Osped Univ Senese, Med Interna 1, Siena, Italy

[10] Azienda Osped Univ Integrata Verona, Med Gen & Malattie Aterotrombot Degenerat, Verona, Italy

[11] Azienda Osped Univ, Policlin Giaccone, Policlin Palermo, Unita Operat Geriatria & Lungodegenza, Palermo, Italy

[12] UOC Med Interna Indirizzo Geriatr Riabilitat, ARNAS Civ, Palermo, Italy

[13] Azienda Osped Univ, Policlin S Orsola Malpighi, Unita Operat Med Interna, Bologna, Italy

[14] Azienda Osped Univ Senese, Unita Operat Complessa Med 2, Siena, Italy

[15] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Osped L DAgostino, Med Interna Univ A Murri, Bari, Italy

[16] Osped Maggiore Policlin, Unita Operat Med Interna IA, Fdn IRCCS Ca Granda, Milan, Italy

[17] Osped Maggiore Policlin, Geriatria, Fdn IRCCS Ca Granda, Milan, Italy

[18] IRCCS Policlin San Matteo Pavia, Clin Med 1, Reparto 11, Pavia, Italy

[19] IRCCS Azienda Osped Univ San Martino IST Genova, Clin Med Interna 2, Genoa, Italy

[20] Osped Bassini Cinisello Balsamo, Div Med, Milan, Italy

[21] Osped Civile Jazzolino Vibo Valentia, Med Interna, Vibo Valentia, Italy

[22] Osped Clinicizzato SS, Clin Med, Chieti, Italy

[23] Osped Giovanni Paolo II Lamezia Terme, Unita Operat Complessa Med Interna, Catanzaro, Italy

[24] Azienda Osped Univ Sassari, Clin Med, Sassari, Italy

[25] Sapienza Univ Roma, Policlin Umberto I, Med Interna & Nutr Clin Policlin Umberto I, Rome, Italy

[26] Policlin Univ A Gemelli, Unita Operat Complessa Med Urgenza & Pronto Socco, Rome, Italy

[27] Spedali Civili Brescia, Geriatr, Brescia, Italy

[28] Univ Campus Biomed, Med Clin Epatol, Rome, Italy

[29] Univ Milano Bicocca, Osped S Gerardo, Unita Operat Geriatria, Monza, Italy

[30] Univ Magna Grecia, Policlin Mater Domini, Unita Operat Complessa Med Interna, Catanzaro, Italy

[31] Azienda Osped Cardinale Panico Tricase, Unita Operat Complessa Med, Lecce, Italy

[32] Azienda Osped Osped San Camillo Forlanini, Med Interna 1, Rome, Italy

[33] Azienda Osped Papa Giovanni XXIII, Med 1, Bergamo, Italy

[34] Azienda Osped Univ Padova, Clin Med 1, Padua, Italy

[35] Azienda Osped Univ St Anna, Unita Operat Clin Med, Ferrara, Italy

[36] Seconda Univ Studi Napoli, Azienda Osped Univ, Div Med Interna & Malattie Nutr Invecchiamento 4, Naples, Italy

[37] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Univ C Frugoni, Bari, Italy

[38] Azienda Sanit Osped Santa Croce & Carle Cunco, SC Med Interna, Cuneo, Italy

[39] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna 1B, Milan, Italy

[40] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, UOC Med Gen Emostatsi & Trombosi, Milan, Italy

[41] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna Alta Intens, Milan, Italy

[42] IRCCS Policlin San Donato, Milan, Italy

[43] Univ Milan, Med Interna, Milan, Italy

[44] Univ Genoa, Med Interna 1, Genoa, Italy

[45] Osped Casorate Primo, ASST Pavia, UOSD Med Interna, Pavia, Italy

[46] Azienda Osped Bolognini Seriate, Osped SS Gerosa& Capitanio Lovere, Unita Operat Complessa Med Gen, Bergamo, Italy

[47] Osped Garibaldi Nesima, Unita Operat Complessa Med Interna, Catania, Italy

[48] Osped Poliambulanza, Med Interna & Geriatira, Brescia, Italy

[49] Univ Torino, Dipartimento Sci Med, Citta Sci & Salute, Med Interna U Indirizzo Urgenza 2, Turin, Italy

[50] Azienda Osped Univ S Anna, Unita Operat Med Osped 2, Ferrara, Italy

来源：

EUROPEAN JOURNAL OF INTERNAL MEDICINE | 2018年 / 55卷

关键词：

Aging; Chronic pain; Undertreatment; Analgesic treatment; Pain management; QUALITY-OF-LIFE; PERSISTENT PAIN; MANAGEMENT; DEMENTIA; DEPRESSION; COMORBIDITY; MORTALITY; ANXIETY; OPIOIDS; IMPACT;

D O I：

10.1016/j.ejim.2018.05.031

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Chronic pain is a frequent characteristic of elderly people and represents an actual and still poorly debated topic. Objective: We investigated pain prevalence and intensity, and its pharmacological therapy in elderly patients hospitalized in 101 internal medicine wards. Methods: Taking advantage of the "REgistro POliterapie Societa Italiana Medicina Interna" (REPOSI), we collected 2535 patients of whom almost a quarter was older than 85 years old. Among them, 582 patients were affected by pain (either chronic or acute) and 296 were diagnosed with chronic pain. Results: Patients with pain showed worse cognitive status, higher depression and comorbidities, and a longer duration of hospital stay compared to those without pain (all p<.0366). Patients with chronic pain revealed lower level of independency in their daily life, worse cognitive status and higher level of depression compared to acute pain patients (all p<.0156). Moreover, most of them were not treated for pain at admission (73.4%) and half of them was not treated with any analgesic drug at discharge (50.5%). This difference affected also the reported levels of pain intensity. Patients who received analgesics at both admission and discharge remained stable (p=.172). Conversely, those not treated at admission who received an analgesic treatment during the hospital stay decreased their perceived pain (p<.0001). Conclusions: Our results show the need to focus more attention on the pharmacological treatment of chronic pain, especially in hospitalized elderly patients, in order to support them and facilitate their daily life after hospital discharge.

引用

页码：35 / 39

页数：5

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