Journal
PAIN
Volume 163, Issue 12, Pages 2457-2465Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000002653
Keywords
CPSP; ICD-11 code; Pain-related affective interference; Pain-related functional interference; Pre-existing chronic pain; Risk factors
Categories
Funding
- European Community
- European Society of Anaesthesiology
- Foundation Research in Anesthesia [223590]
- Intensive Care Medicine of Bern University Hospital
- EU
- DFG
- BMBF
- EFIC
- Pfizer
- Mundipharma
- Gruenenthal
- European Community
- European Society of Anaesthesiology
- Foundation Research in Anesthesia
- Intensive Care Medicine of Bern University Hospital
- EU
- DFG
- BMBF
- EFIC
- Pfizer
- Mundipharma
- Gruenenthal
Ask authors/readers for more resources
This study investigated the incidence of Chronic Postsurgical Pain (CPSP) by combining pain intensity and pain-related interference with function in patient-reported outcomes (PROs). A more comprehensive assessment of pain and interference resulted in lower CPSP rates than previously reported.
Chronic postsurgical pain (CPSP) is defined by pain intensity and pain-related functional interference. This study included measures of function in a composite score of patient-reported outcomes (PROs) to investigate the incidence of CPSP. Registry data were analyzed for PROs 1 day and 12 months postoperatively. Based on pain intensity and pain-related interference with function, patients were allocated to the groups CPSPF (at least moderate pain with interference), mixed (milder symptoms), and no CPSPF. The incidence of CPSPF was compared with CPSP rates referring to published data. Variables associated with the PRO-12 score (composite PROs at 12 months; numeric rating scale 0-10) were analyzed by linear regression analysis. Of 2319 patients, 8.6%, 32.5%, and 58.9% were allocated to the groups CPSPF, mixed, and no CPSPF, respectively. Exclusion of patients whose pain scores did not increase compared with the preoperative status, resulted in a 3.3% incidence. Of the patients without pre-existing pain, 4.1% had CPSPF. Previously published pain cutoffs of numeric rating scale >0, >= 3, or >= 4, used to define CPSP, produced rates of 37.5%, 9.7%, and 5.7%. Pre-existing chronic pain, preoperative opioid medication, and type of surgery were associated with the PRO-12 score (all P < 0.05). Opioid doses and PROs 24 hours postoperatively improved the fit of the regression model. A more comprehensive assessment of pain and interference resulted in lower CPSP rates than previously reported. Although inclusion of CPSP in the ICD-11 is a welcome step, evaluation of pain characteristics would be helpful in differentiation between CPSPF and continuation of pre-existing chronic pain.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available