An international multicentre validation study of a pain classification system for cancer patients
An international multicentre validation study of a pain classification system for cancer patients
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DOI：
10.1016/j.ejca.2010.04.017
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发表时间：
2010-11-01
影响因子：
8.4
通讯作者：
Hanson, John
中科院分区：
文献类型：
--
作者：
Fainsinger, Robin L.;Nekolaichuk, Cheryl;Hanson, John
本研究的主要目的是评估埃德蒙顿癌症疼痛分类系统（ECS CP）在不同的晚期癌症患者国际样本中的预测有效性。我们假设，与不太复杂的疼痛综合征患者相比，有问题的疼痛综合征患者需要更多的时间来达到稳定的疼痛控制，更复杂的镇痛方案和更高的阿片类药物剂量。（n = 1100）从加拿大、美国、爱尔兰、以色列、澳大利亚和新西兰的11个姑息治疗中心招募（每个研究中心100名）姑息治疗专家为每名患者完成ECS CP，记录每日患者疼痛评分、疼痛突破剂量数量、疼痛辅助剂类型和阿片类药物消耗量，直至研究终点（疼痛控制稳定、出院和死亡）结果944/1100例（86%）患者存在疼痛综合征在单因素分析中，较年轻的神经性疼痛事件疼痛、心理困扰、成瘾行为和初始疼痛强度与达到稳定疼痛控制的天数显著相关。神经病理性疼痛、偶发性疼痛、心理困扰或疼痛强度较高的患者需要更多的辅助治疗和更高的阿片类药物剂量，而有成瘾行为的患者只需要更高的阿片类药物剂量，认知缺陷与疼痛控制稳定的天数较少、阿片类药物剂量较低和止痛药较少相关。表明ECS CP可以在一系列实践环境和国家中预测疼痛复杂性（C）2010 Elsevier Ltd保留所有权利
Purpose The study s primary objective was to assess predictive validity of the Edmonton Classification System for Cancer Pain (ECS CP) in a diverse international sample of advanced cancer patients We hypothesised that patients with problematic pain syndromes would require more time to achieve stable pain control more complicated analge sic regimens and higher opioid doses than patients with less complex pain syndromesMethods Patients with advanced cancer (n = 1100) were recruited from 11 palliative care sites in Canada USA Ireland Israel Australia and New Zealand (100 per site) Palliative care specialists completed the ECS CP for each patient Daily patient pain ratings number of breakthrough pain doses types of pain adjuvants and opioid consumption were recorded until study end point e stable pain control discharge and death)Results A pain syndrome was present in 944/1100 (86%) In univariate analysis younger age neuropathic pain incident pain psychological distress addictive behaviour and initial pain intensity were significantly associated with more days to achieve stable pain control In multivariate analysis younger age neuropathic pain incident pain psychological distress and pain intensity were independently associated with days to achieve stable pain control Patients with neuropathic pain incident pain psychological distress or higher pain intensity required more adjuvants and higher final opioid doses those with addictive behaviour required only higher final opioid doses Cognitive deficit was associated with fewer days to stable pain control lower final opioid doses and fewer pain adjuvantsConclusion The replication of previous findings suggests that the ECS CP can predict pain complexity in a range of practice settings and countries (C) 2010 Elsevier Ltd All rights reserved