title: The Prevalence and Characteristics of Pain in Critically Ill Cancer Patients: A Prospective Nonrandomized Observational Study.
abstract: BACKGROUND
  Pain is a distressing symptom common to all stages and ubiquitous at all levels of care in cancer patients. However, there is a lack of scientific literature on prevalence, severity, predictors, and the quality of pain in cancer patients admitted to an Intensive Care Unit (ICU).
  
  
  OBJECTIVE
  To elucidate the prevalence of pain, moderate to severe pain, neuropathic pain, chronic pain, and pain as the most distressing symptom in critically ill-cancer patients at the time of ICU admission.
  
  
  METHODS
  We prospectively interviewed 126 patients within first 24 h of admission to a medical ICU. The patients were assessed for the presence of pain, its severity, sites, duration, nature, and its impact as a distressing symptom. Numerical Rating Scale and self-report version of Leeds Assessment of Neuropathic Signs and Symptoms were used to elucidate intensity of pain and neuropathic pain, respectively. Demographic characteristics such as age and sex, primary site, and stage of cancer were considered for a possible correlation with the prevalence of pain.
  
  
  RESULTS
  Of 126 patients included in the study 95 (75.40%), 79 (62.70%), 34 (26.98%), and 17 (13.49%) patients had pain, moderate-severe, chronic, and neuropathic pain, respectively. The average duration of pain was 171.16 ± 716.50 days. Totally, 58 (46.03%) and 42 (42.01%) patients had at least one and more than equal to 2 neuropathic pain symptoms, respectively. The primary malignancies associated with the highest prevalence of pain were genitourinary, hematological, and head and neck whereas breast and lung cancers were associated with the highest prevalence of neuropathic and chronic pain, respectively.
  
  
  CONCLUSIONS
  The prevalence of pain among critically ill-cancer patients is high. Assessment for pain at the time of ICU admission would ensure appropriate assessment for the presence, type, severity, and the significance imparted to it.
authors.affiliation: Department of Anaesthesia, Shri Guru Ram Rai Institute of Medical and Health Sciences, Shri Mahant Indiresh Hospital, Dehradun, Uttarakhand, India.
authors.forename: Mayank
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesia, Medical Intensive Care Unit, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Malvinder Singh
authors.initials: MS
authors.lastname: Sahi
authors.affiliation: Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Bhargava
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Vineet
authors.initials: V
authors.lastname: Talwar
keywords: Cancer; Critically ill; Intensive Care Unit; Neuropathic; Pain; Severe pain