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Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis
OBJECTIVE: To describe the pain intensity among hospitalized patients with calciphylaxis, elucidate the factors associated with pain improvement, and examine the link between pain improvement and clinical outcomes. PATIENTS AND METHODS: Patients were identified from the Partners Research Patient Dat...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9880339/ https://www.ncbi.nlm.nih.gov/pubmed/36712824 http://dx.doi.org/10.1016/j.mayocpiqo.2022.12.006 |
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author | Wen, Wen Krinsky, Scott Kroshinsky, Daniela Durant, Olivia He, Jeffrey Seethapathy, Rituvanthikaa Hillien, Shelsea Annette St. Mengesha, Beza Malhotra, Rajeev Chitalia, Vipul Nazarian, Rosalynn M. Goverman, Jeremy Lyons, Karen S. Nigwekar, Sagar U. |
author_facet | Wen, Wen Krinsky, Scott Kroshinsky, Daniela Durant, Olivia He, Jeffrey Seethapathy, Rituvanthikaa Hillien, Shelsea Annette St. Mengesha, Beza Malhotra, Rajeev Chitalia, Vipul Nazarian, Rosalynn M. Goverman, Jeremy Lyons, Karen S. Nigwekar, Sagar U. |
author_sort | Wen, Wen |
collection | PubMed |
description | OBJECTIVE: To describe the pain intensity among hospitalized patients with calciphylaxis, elucidate the factors associated with pain improvement, and examine the link between pain improvement and clinical outcomes. PATIENTS AND METHODS: Patients were identified from the Partners Research Patient Data Registry and the Partners Calciphylaxis Registry and Biorepository (Clinicaltrials.gov ID: NCT03032835). Those with calciphylaxis requiring hospitalization for at least 14 consecutive days during the study period from May 2016 through December 2021 were included. Pain intensity was assessed using patient-reported pain scores on numerical rating scales from 0 to 10. Associations between pain improvement and clinical outcomes, including lesion improvement, amputation, and mortality, were examined using univariate and multivariate regression models. RESULTS: Our analysis included 111 patients (age, 58±14 years; men, 40%; on maintenance dialysis, 79%). No significant improvement of pain intensity was observed over the 14 days of hospitalization (mean difference, −0.71; P=.08). However, among 49 (44.1%) patients who showed at least 1-point improvement in the pain score, there was an association with surgical debridement during hospitalization (odds ratio, 3.37; 95% CI, 1.17-9.67; P=.02). Hyperbaric oxygen therapy was associated with pain improvement (odds ratio, 5.38; 95% CI, 1.14-25.50; P=.03) in patients on maintenance dialysis. Pain improvement was associated with lower rates of subsequent amputation at 6 months of follow up (6% vs 13%; P<.05) but did not predict lesion improvement or survival. CONCLUSION: Pain control remains a challenge among hospitalized patients with calciphylaxis. Surgical debridement and hyperbaric oxygen therapy may improve pain intensity. Pain improvement predicted a lower risk of future amputation. |
format | Online Article Text |
id | pubmed-9880339 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-98803392023-01-28 Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis Wen, Wen Krinsky, Scott Kroshinsky, Daniela Durant, Olivia He, Jeffrey Seethapathy, Rituvanthikaa Hillien, Shelsea Annette St. Mengesha, Beza Malhotra, Rajeev Chitalia, Vipul Nazarian, Rosalynn M. Goverman, Jeremy Lyons, Karen S. Nigwekar, Sagar U. Mayo Clin Proc Innov Qual Outcomes Original Article OBJECTIVE: To describe the pain intensity among hospitalized patients with calciphylaxis, elucidate the factors associated with pain improvement, and examine the link between pain improvement and clinical outcomes. PATIENTS AND METHODS: Patients were identified from the Partners Research Patient Data Registry and the Partners Calciphylaxis Registry and Biorepository (Clinicaltrials.gov ID: NCT03032835). Those with calciphylaxis requiring hospitalization for at least 14 consecutive days during the study period from May 2016 through December 2021 were included. Pain intensity was assessed using patient-reported pain scores on numerical rating scales from 0 to 10. Associations between pain improvement and clinical outcomes, including lesion improvement, amputation, and mortality, were examined using univariate and multivariate regression models. RESULTS: Our analysis included 111 patients (age, 58±14 years; men, 40%; on maintenance dialysis, 79%). No significant improvement of pain intensity was observed over the 14 days of hospitalization (mean difference, −0.71; P=.08). However, among 49 (44.1%) patients who showed at least 1-point improvement in the pain score, there was an association with surgical debridement during hospitalization (odds ratio, 3.37; 95% CI, 1.17-9.67; P=.02). Hyperbaric oxygen therapy was associated with pain improvement (odds ratio, 5.38; 95% CI, 1.14-25.50; P=.03) in patients on maintenance dialysis. Pain improvement was associated with lower rates of subsequent amputation at 6 months of follow up (6% vs 13%; P<.05) but did not predict lesion improvement or survival. CONCLUSION: Pain control remains a challenge among hospitalized patients with calciphylaxis. Surgical debridement and hyperbaric oxygen therapy may improve pain intensity. Pain improvement predicted a lower risk of future amputation. Elsevier 2023-01-24 /pmc/articles/PMC9880339/ /pubmed/36712824 http://dx.doi.org/10.1016/j.mayocpiqo.2022.12.006 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Wen, Wen Krinsky, Scott Kroshinsky, Daniela Durant, Olivia He, Jeffrey Seethapathy, Rituvanthikaa Hillien, Shelsea Annette St. Mengesha, Beza Malhotra, Rajeev Chitalia, Vipul Nazarian, Rosalynn M. Goverman, Jeremy Lyons, Karen S. Nigwekar, Sagar U. Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis |
title | Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis |
title_full | Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis |
title_fullStr | Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis |
title_full_unstemmed | Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis |
title_short | Patient-Reported and Clinical Outcomes Among Patients With Calciphylaxis |
title_sort | patient-reported and clinical outcomes among patients with calciphylaxis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9880339/ https://www.ncbi.nlm.nih.gov/pubmed/36712824 http://dx.doi.org/10.1016/j.mayocpiqo.2022.12.006 |
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