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Akbari Z, Jesmi A A, Mahdavifar N, Taj A, Mozari S. Relationship of the Critical Care Pain Observation Tool Score With the APACHE II Score, Sedation Level, and Ventilation Parameters in Critically Ill Patients Under Mechanical Ventilation. JHNM 2024; 34 (4) :301-308
URL: http://hnmj.gums.ac.ir/article-1-2088-en.html

Introduction: Pain is a persistent concern and a common symptom in critically ill patients. It is an increasingly unpleasant experience in patients discharged from the intensive care units (ICUs). 
Objective: This study aims to evaluate the correlation of pain intensity with the acute physiology and chronic health evaluation (APACHE II) score, the Ramsay sedation scale (RSS) score, and some ventilation parameters in patients under mechanical ventilation admitted to the ICU. 
Materials and Methods: This cross-sectional study was conducted on 40 intubated patients under mechanical ventilation at the trauma ICU of a hospital in Sabzevar, Iran, from November 2020 to May 2021. The samples were selected using a convenience sampling method. Data were collected using the critical-care pain observation tool (CPOT), APACHE II, RSS, and a form surveying demographic and ventilation parameters. Data analysis was performed using descriptive statistics, Spearman’s correlation test, and Mann-Whitney U test. The significance level was set at 0.05.
Results: Among participants, 87.5% were male (n=35) and 12.5% female (n=5). Their mean age was 42.80±17.12 years, ranged 18-83 years. The CPOT score at rest (r=0.78) and during suctioning (r=0.72) was significantly correlated with the APACHE II score (P=0.001). It also had a significant association with the RSS score at rest and during suctioning and position change (P=0.001), surgical diagnosis (P=0.002 at rest, P=0.001 during suctioning), and using sedatives (P=0.001 at rest, P=0.001 during procedure). However, no significant correlation was observed between the CPOT score and ventilation parameters. Pain intensity was significantly different among patients with and without a history of addiction (r=0.68, P=0.015 at rest; P=0.002 during suctioning).
Conclusion: Given the correlation of the pain intensity with the APACHE II and RSS scores in patients under mechanical ventilation, these factors should be considered by healthcare planners to promote the quality of care and effective management of pain in these patients admitted to ICUs.