Severity of chronic pain affects health care utilization after kidney transplantation.
BACKGROUND
While the association between chronic pain and high health care utilization is a known issue in the general population, this relation has not been well studied among kidney transplantation patients.


METHODS
The subjects were first-time kidney transplant recipients engrafted between 2003 and 2006 and 6 months to 5 years postoperatively. Using SF-36 Bodily Pain Scale, patients were categorized in three groups: group I, those with scores over 66.6; group II, between 66.6 and 33.3; and group III, over 33.3. The subjects' health care utilization was prospectively assessed by recording the number of hospital admission days and the frequency of home nurse visits, outpatient physician visits, and emergency department visits for any medical reason in a 6-month period.


RESULTS
A stepwise increase in the frequency of patients admitted to the hospital (P=.017), and those referred to emergency departments (P=.007) was correlated with greater severity of pain in the three groups. However, the frequency of patients having outpatient physician visits (P=.30) or home nurse visits (P=.387) did not vary significantly. Similarly, with increased pain severity, an increase was observed in the number of emergency department visits (P=.005) and duration of hospital stays (P=.049), but not in the number of home nurse (P=.890) or physician visits (P=.112).


CONCLUSIONS
The severity of pain seems to increase the amount of health care use among kidney transplant patients. To minimize associated costs, appropriate pain rehabilitation programs are suggested.
Hollisaaz
M-T
MT
Nephrology/Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran.
Noorbala
M-H
MH
Irani
N
N
Bahaeloo-Horeh
S
S
Assari
S
S
Saadat
S-H
SH
Araghizadeh
H
H
Rezaie
Y
Y
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007492:Iran; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D012189:Retrospective Studies