A Novel Measure of Pain Location in Adults with Sickle Cell Disease.
Khulud Abudawood, Saunjoo L Yoon, Yingwei Yao and 4 others
PMID 36261305WHAT IT FOUND
Adults with sickle cell disease marked about 14% of their body surface as painful.
Pain intensity rose from 4.4/10 at clinic to 7.1/10 in hospital, while pain location and number of pain words stayed similar.
Key findings
01During outpatient visits and inpatient stays, adults with sickle cell disease marked a mean 14.4% and 13.5% of body surface area as painful, respectively.
02Pain intensity was significantly higher during inpatient stays than outpatient visits (mean 7.1 vs 4.4), while number of pain words chosen and pain-affected body surface area did not differ significantly.
03Pain extent was positively associated with the number of pain quality words chosen (r=.31 outpatient, r=.37 inpatient), but pain intensity was not significantly associated with pain extent or quality word count.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used data collected between 2007 and 2011 at one hospital system in Chicago, so it may not reflect current care or other settings. Of the 116 patients with both outpatient and inpatient pain measures, 17 were excluded for missing location or quality data, leaving 99 patients. The sample was mostly African American adults, and the paper does not say how far this applies to other populations. The study reports associations between pain location, quality, and intensity; it does not show that measuring body surface area improves diagnosis or treatment. The digital body-outline tool and image-analysis method are research tools, not a commercially available clinical workflow, and the first completion took about 20 minutes. Not all inpatient measures were taken on the first admission day, although day 1 versus later comparisons did not materially change the main results.
Declared interests
The supplied metadata lists NIH extramural and non-U.S. government research support; no author disclosures are included in the text.
The easy way to misread this
Do not conclude that a pain-affected body surface area percentage is a validated clinical test for sickle cell pain. The paper shows a research method and associations; it does not prove that using the measure changes treatment or outcomes.