期刊
EUROPACE
卷 23, 期 5, 页码 748-756出版社
OXFORD UNIV PRESS
DOI: 10.1093/europace/euaa349
关键词
Cardiac implantable electronic device implantation; Pacemaker; Implantable cardioverter-defibrillator; Predictors of post-operative pain; Pain prediction score; BRUISE CONTROL trials
资金
- Canadian Institutes of Health Research (CIHR)
- CIHR Clinician Scientist Award
- University of Ottawa Heart Institute Academic Medical Organization Alternate Funding Program (Ministry of Health of Ontario)
- Heart and Stroke Foundation of Canada [G-14-0005725]
- Fonds de recherche du Quebec-Sante (FRQS) Clinical Research Scholar Award
- Bayer HealthCare AG, Leverkusen, Germany
- Pfizer
- Bristol-Myers Squibb, New York, NY, USA
- Boehringer Ingelheim, Germany
The study identified multiple predictors of post-operative pain after CIED insertion and developed a prediction score for post-operative pain that can help identify individuals at risk for significant post-operative pain.
Aims Post-operative pain following cardiac implantable electronic device (CIED) insertion is associated with patient dissatisfaction, emotional distress, and emergency department visits. We sought to identify factors associated with post-operative pain and develop a prediction score for post-operative pain. Methods and results All patients from the BRUISE CONTROL-1 and 2 trials were included in this analysis. A validated Visual Analogue Scale (VAS) was used to assess the severity of pain related to CIED implant procedures. Patients were asked to grade the most severe post-operative pain, average post-operative pain, and pain on the day of the first post-operative clinic. Multivariable regression analyses were performed to identify predictors of significant post-operative pain and to develop a pain-prediction score. A total of 1308 patients were included. Multivariable regression analysis found that the presence of post-operative clinically significant haematoma {CSH; P value < 0.001; odds ratio (OR) 3.82 [95% confidence interval (CI): 2.37-6.16]}, de novo CIED implantation [P value < 0.001; OR 1.90 (95% CI: 1.47-2.46)], female sex [P value < 0.001; OR 1.61 (95% CI: 1.22-2.12)], younger age [<65 years; P value < 0.001; OR 1.54 (95% CI: 1.14-2.10)], and lower body mass index [<20 kg/m(2); P value < 0.05; OR 2.05 (95% CI: 0.98-4.28)] demonstrated strong and independent associations with increased post-operative pain. An 11-point post-operative pain prediction score was developed using the data. Conclusion Our study has identified multiple predictors of post-operative pain after CIED insertion. We have developed a prediction score for post-operative pain that can be used to identify individuals at risk of experiencing significant post-operative pain.
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