Predictive Factors for Access-Site Pain Chronicity after Percutaneous Coronary Intervention via Radial Artery Access

经桡动脉入路行经皮冠状动脉介入治疗后穿刺部位疼痛慢性化的预测因素

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Abstract

OBJECTIVES: The aim of this study is to assess the prevalence and predictive factors for developing chronic access-site (A-S) pain after percutaneous coronary intervention (PCI) via radial artery access. METHODS: Data of selected patients (n = 161) who underwent elective PCI were collected prospectively and analysed in 2020. Verbal analogue scale was used to evaluate pain intensity after 12, 24, and 48 h and 3 months after PCI. The univariate logistic regression analysis was used. RESULTS: Pain prevalence decreased from 29% straight after PCI and 54% two hours later to 3.7% following 3 months after procedure. The predictors for A-S pain chronicity are diabetes (OR = 5.77 95% CI (1.07-31.08), p = 0.041), hematoma (OR = 6.48, 95% CI (1.06-39.66), p = 0.043), A-S hand neuropathy (OR = 19.93 95% CI (1.27-312.32), p = 0.033), A-S pain immediately after PCI (OR = 14.60 95% CI (1.63-130.27), p = 0.016), after 12 h (OR = 17.2 95% CI (1.60-185.27), p = 0.019), 24 h (OR = 48 95% CI (4.87-487), p = 0.01), and 48 h (OR = 23.46 95% CI (3.81-144.17), p = 0.001), and pain intensity immediately after procedure (OR = 3.30 95% CI (1.65-6.60), p = 0.001), after 2 h (OR = 2.56 95% CI (1.15-5.73), p = 0.022), after 12 h (OR = 3.02 95% CI (1.70-5.39), p < 0.001), after 24 h (OR = 3.58 95% CI (1.90-6.74), p < 0.001), and after 48 h (OR = 2.89 95% CI (1.72-4.87), p < 0.001). Pain control was performed with Ketoprofen and Ibuprofen as most used NSAIDs. 10 mg of Morphine intravenously was the choice from strong opioids if necessary. CONCLUSIONS: The prevalence of chronic A-S pain is 3.7%. Main predictive factors for the A-S pain chronicity are diabetes, hematoma, and persistent pain and pain intensity during 48 h period after PCI.

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