Pain and Hospitalization in Palliative Care

Abstract

Introduction: Pain is one of the most prevalent symptoms among patients in palliative care (PC), especially in advanced cancer, causing harmful impacts on quality of life. Objective: To assess the time required for pain control and its influence on the length of stay of patients in PC. Method: Post hoc analysis of the profile of hospitalization in a public oncology palliative care hospital in Rio de Janeiro was carried out between September and November 2016. Hospitalizations were followed longitudinally by reviewing medical charts with daily collection of the Numerical Rating Scale (NRS). Pain was considered controlled when NRS was zero. Among those hospitalized with uncontrolled pain, the time needed to control the symptom was calculated. Results: There were 429 hospitalization episodes with the presence of the pain symptom (controlled or not). The length of hospital stay was longer in hospitalizations with the pain symptom present (8.2 days versus 6.3 days without pain). Pain was not controlled on admission in 33% of the episodes. The mean time for pain control was 2.1 days. Both pain without control when hospitalized and delay in more than 24 hours to control it were associated with longer mean hospital stay: 7.9; 9.5; 8.7 and 11.2 days respectively. Conclusion: The findings confirm the high prevalence of pain among patients in oncology PC, its impact on motivating and prolonging a hospital stay, and the importance of the action of a specialized team.