Chronic, acute and acute-on-chronic pain prevalence in a tertiary care hospital setting

P. Notaro, P. Nunnari, N. Ladiana, M.C. Montagna, M. Lusignani, M. Moreno, M. Bosio

Pain Medicine Unit, Department of Neuroscience, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy. paolo.notaro@ospedaleniguarda.it

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• Pharmacology

OBJECTIVE: The aim of the study was to develop appropriate pain therapy and prevention plans; pain needs to be understood in terms of prevalence and associated predictor factors in hospital and primary care. The purpose of our research was to assess the prevalence of chronic, acute, and acute-on-chronic pain, and ascertain the effects of several factors on the likelihood of pain in an Italian Tertiary Care Hospital.

PATIENTS AND METHODS: This is a prevalence study in which the primary outcome was the prevalence rate of chronic pain inpatients. Fisher’s exact tests and binomial logistic regression were performed for the prevalence measures, and to ascertain the effects of Hospital Unit, sex, age, surgery and preexisting chronic pain on the likelihood of pain during the hospitalization, respectively.

RESULTS: Chronic pain was reported in one-fifth of inpatients [21.7% (95% CI: 0.1764, 0.2625)], with a high prevalence of pain-related interference on sleep and emotional status. Nearly 70% of chronic pain patients accused acute-on-chronic pain [15.3% (95% CI: 0.1178, 0.1934)]. High pain prevalence rates were assessed at the time of the interview (37.3%; 95% CI: 0.3234, 0.4239) and in the last 24 hours of hospitalization (53.3%; 95% CI: 0.4814, 0.5850). A 2.7 and 2.6 higher odds to suffer from pain during the hospitalization were associated with surgery, and preexisting chronic, respectively.

CONCLUSIONS: This study raises awareness of the necessity to refine pain assessment and management in hospital and outpatient services. The promotion and enhancement of hospital-territory integration are essential for improving pain prescribing practices and increasing patient safety.

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