Identifier les patients à risque de douleur chronique après un traumatisme craniocérébral modéré/sévère dès les premiers jours d'hospitalisation aux soins intensifs

 

Caroline Arbour

CIUSSS du Nord-de-l'Île-de-Montréal

 

Domaine : neurosciences, santé mentale et toxicomanies

Programme Consortium pour le développement de la recherche en traumatologie - Volet 1

Concours 2018-2019

Year after year, chronic pain remains among the most commonly reported sequelae 6 to 12 months after moderate to severe traumatic brain injury (TBI). In addition to undermining the quality of life, persistent and disabling pain affects the recovery and work reintegration of many patients who survive a TBI. The human and monetary costs of pain after TBI are therefore enormous. However, not all patients will develop chronic pain after a major trauma. Unfortunately, we are currently unable to identify patients who will develop chronic pain after moderate to severe TBI. Still, we know that the physiopathological changes related to the persistence of pain begin in the first 7 days following a traumatic injury to the nervous system. For patients with moderate to severe TBI, this period usually corresponds to the intensive care unit period. Identifying at-risk TBI patients as soon as they are in the intensive care would allow the analgesic approach to be adjusted and the initiation of an interprofessional follow-up protocol to prevent the chronicisation of pain.

This project aims to identify, within the first days of hospitalization, individuals at risk of developing persistent and disabling pain after moderate to severe TBI. To achieve this, clinical variables relating to the severity of trauma (TBI and spinal cord), inflammation and pain relief will be documented. Age as well as analgesics and sedatives medication will also be documented. The ability of these variables to predict chronic pain 6 to 12 months post-TBI will be evaluated. Ultimately, this project aims to establish a standardized assessment protocol for the early identification of moderate to severe TBI patients at risk for chronic pain during their recovery in the intensive care unit.