Background and Goal of Study
Post-Intensive Care Syndrome (PICS) is defined as the deterioration of recent onset or worsening of a previous deterioration in the mental, physical or cognitive state. Occurs as a consequence of a critical illness, and which persists after acute hospital care. Our aim is to determine the incidence of chronic pain 3 months after ICU discharge and the impact on quality of life.

Materials and Methods
After getting approval from the ethical committee of Hospital Clínic, a prospective observational study was conducted since March of 2017.Exclusion criteria included neurological and psychiatric pathology and history of substance abuse. Patients with written informed consent were evaluated: Verbal Analogue Scale (VAS), existence of neuropathic pain (DN4 Scale), presence of previous chronic pain, incidence of Anxiety and Depression (HAD test), EuroQol-5D test to assess quality of life, Duke test to register social support, Pfeiffer test to assess cognitive impairment, and Post-traumatic Stress Disorder (PTSD) test. 3 months after ICU discharge, patients were invited to attend a follow-up clinic visit for re-evaluation. We used descriptive statistics and McNemar test for qualitative variables.

Results and Discussion
Preliminary results until December 2017 are presented. A total of 122 patients were screening for eligibility, 75 agreed to participate and 48 were invited to the three-month re-evaluation with response rate of 67.8%(33 patients). 61(19-87) year-old, 70,8% males, APACHE II score 12(3-32), ICU length stay 5(3-38). VAS at ICU stay was 7(IQR 0-10) and 3 months after discharge was 2 (IQR 0-9, Wilcoxon test p < 0.001). Results showed an increased in chronic pain incidence although differences were not statistically significant (25% in front 30% after 3 months, p 0.549), taking into consideration almost half of patients have not been yet re-evaluated. Differences in neuropathic pain before and after ICU stay were statistically significant (20.8% in front 39%, p= 0.013).No differences were found in social support and cognitive impairment. Furthermore, 45%, 33% and 18% reported anxiety, depression and PTSD respectively 3 months after ICU discharge.

Conclusion
Data suggests that patients who required ICU stay present more incidence of neuropathic pain after 3 months. Anxiety, depression and PTSD have been reported so these patients are susceptible to develop PICS. Identification of PICS is fundamental for defining an early treatment strategy.


07 / Incidence of chronic pain and quality of life three months after ICU discharge