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Published on: August 1, 2017
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Detecting Pain Correlates With Recovery in Acute Brain Injury Patients With Disorders of Consciousness
Julia Houshmand1,2, Brian Manolovitz1, Kelsey E Ladd2
1Department of Neurology, University of Miami Miller School of Medicine, Miami, FL.
Critical Care Explorations
|September 24, 2025
Summary
Pain is common in acute brain injury (ABI) patients with disorders of consciousness (DoC). Higher pain burden, measured by the Critical Care Pain Observation Tool (CPOT), is linked to better recovery of consciousness and function.
Area of Science:
- Neurology
- Critical Care Medicine
- Pain Management
Background:
- Patients with acute brain injury (ABI) and disorders of consciousness (DoC) often experience pain.
- Assessing pain in non-communicative patients is challenging.
- The Critical Care Pain Observation Tool (CPOT) is widely used in intensive care units (ICUs).
Purpose of the Study:
- To evaluate pain using the CPOT score in ABI patients with DoC.
- To determine if pain burden can serve as a biomarker for recovery in these patients.
Main Methods:
- Prospective observational study conducted in a Neuroscience ICU from 2020-2024.
- Included 110 ABI patients with DoC (traumatic brain injury, intracerebral hemorrhage, subarachnoid hemorrhage).
- Assessed pain using CPOT scores and recovery using the Glasgow Outcome Scale-Extended (GOSE) at 3, 6, and 12 months.
Main Results:
- 56% of patients had traumatic brain injury; average age was 50 years, with 76% males.
- 75% of patients experienced moderate/severe pain burden (≥5%).
- Higher pain burden correlated with increased odds of consciousness (GOSE ≥ 3) and functional recovery (GOSE ≥ 4) at 12 months, even after adjusting for covariates.
Conclusions:
- Pain, as measured by the CPOT score, is prevalent in ABI patients with DoC.
- The burden of pain is associated with consciousness and functional recovery outcomes at 3, 6, and 12 months.
- CPOT scores may serve as a potential biomarker for predicting recovery in this patient population.
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