The following is the summary of “A Novel Measure of Pain Location in Adults with Sickle Cell Disease” published in the December 2022 issue of Pain management by Abudawood, et al.
Despite the importance of pain quality and pain location and distribution for clinical diagnosis and treatment of sickle cell disease pain, pain intensity continues to be the primary focus of clinical assessment. There needs to be more data regarding the location of pain or the relationship between severity and quality in individuals with SCD, partly due to measurement problems. Their objective was to determine if there was a correlation between pain quality and intensity as assessed in outpatient and inpatient settings and specific pain locations among people with sickle cell disease.
Researchers drew from a preexisting longitudinal dataset that had been prospectively gathered using the robust and trustworthy tablet-based PAINReportItⓇ. Location, intensity, and quality of pain were recorded from adults (n=99) with sickle cell disease at 2 points in time: at a routine outpatient clinic visit and again during a subsequent hospitalization. Investigators determined how much of their bodies were in pain by analyzing digital sketches of their bodies made with the ImageJ program. They used Pearson’s correlations and paired t-tests to compare the correlation between the area of the body that hurts and other pain characteristics for both inpatient and outpatient settings. When patients went to their doctor’s office, pain affected 14.4% 15.0% of their body surface area (min-max: 0%-90.2%), but during hospitalization, it affected 13.5% ± 14.7% (min-max: 0%-73.0%). For both visits, pain quality scores were positively correlated with pain area, although pain intensity scores were not.
The average pain intensity during an inpatient stay was considerably higher than during an outpatient visit (P<.001), however, there were no significant differences between visits in terms of pain quality (P=.12) or body surface area (P=.60). The link between Sickle Cell Disease(SCD) pain quality and body surface area, but not pain severity during outpatient or inpatient visits, is puzzling. More investigation into these results is needed, as is an analysis of the clinical value of pain-affected body surface area for chronic sickle cell disease pain and acute sickle cell disease crisis pain.