Prevalence of pain in the last 2 weeks of life in hospitalized pediatric patients

Sarah Bastidas-Legarda, Paediatrics Service, Clínica Versalles, Fundación Clínica Infantil Club Noel, Cali, Colombia
María A. Flores-Muñoz, Pain Clinic, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
Elisa Hernández-Ramírez, Pain Clinic, Hospital General de México Dr. Eduardo Liceaga. Mexico City, Mexico
Carolina Gutiérrez-Cortés, Paediatrics Service, Hospital Central Militar, Bogotá,Colombia

Introduction: Pain is a very common symptom in children who have a complex, chronic, life-threatening or life-limiting disease, generating a negative impact on the quality of life of the child and his or her family. There is very limited evidence regarding end-stage symptoms in pediatric patients receiving palliative care; Baumann et al. described in 2021 the presence of pain in 56% of their terminally ill patients. So far, there have been no studies in Latin America on the prevalence of pain in the last weeks of life in pediatric patients. Objective: The study aimed to determine the prevalence of pain in the past 2 weeks of life in children who died in the Hospital in the past 5 years. Materials: A retrospective, observational, and longitudinal study was carried out in which the records of patients over 1 month of age and under 18 years of age who died in hospital were included. Results: The records of 98 patients who died during their in-hospital stay were obtained, of which 52 reported the presence of pain in their past 2 weeks of life. Most of the patients were teenagers; oncological pathologies were the most frequent. In less than half of the patients, the use of a tool to assess the intensity of pain was reported, with the verbal numerical scale being the most used. Severe pain was reported in nearly half of the patients, and in a quarter of the children, its intensity was not described. About 71.2% of the children were managed with opioids (alone or in combination with other drugs). Only a third of the subjects were evaluated by the Algology service Pediatric. Conclusions: Timely identification and treatment of pain, especially in terminal phases, is essential to reduce the suffering and agony of these patients. To this end, its assessment by the Pediatric Algology service can favor comprehensive management and adequate control of the symptom.

Keywords: Pediatrics. Pain. Terminal phase.