4.6 Article

Presurgical distress about bodily sensations predicts chronic postsurgical pain intensity and disability 6 months after cardiothoracic surgery

期刊

PAIN
卷 163, 期 1, 页码 159-169

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000002325

关键词

Somatic awareness; Somatic distress; Somatization; Pain catastrophizing; Depression; Anxiety; Chronic postsurgical pain; Pain intensity; Pain disability; Cardiothoracic surgery

资金

  1. Fonds de recherche du Quebec-Sante (FRQS)
  2. Ontario Graduate Scholarship (OGS)
  3. Canadian Institutes of Health Research (CIHR) Canada Research Chair in Health Psychology
  4. Department of Anesthesia and Pain Medicine at the University of Toronto

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The study found that presurgical distress over bodily sensations predicts greater chronic pain intensity and disability 6 months after cardiothoracic surgery. Presurgical treatment to diminish such distress may prevent or minimize chronic pain and disability.
Chronic postsurgical pain (CPSP) and disability after cardiothoracic surgery are highly prevalent and difficult to treat. Researchers have explored a variety of presurgical risk factors for CPSP and disability after cardiothoracic surgery, including one study that examined distress from bodily sensations. The current prospective, longitudinal study sought to extend previous research by investigating presurgical distress about bodily sensations as a risk factor for CPSP and disability after cardiothoracic surgery while controlling for several other potential psychosocial predictors. Participants included 543 adults undergoing nonemergency cardiac or thoracic surgery who were followed over 6 months postsurgically. Before surgery, participants completed demographic, clinical, and psychological questionnaires. Six months after surgery, participants reported the intensity of CPSP on a 0 to 10 numeric rating scale and pain disability, measured by the Pain Disability Index. Multinomial logistic regression analyses were conducted to evaluate the degree to which presurgical measures predicted pain outcomes 6 months after surgery. The results showed that CPSP intensity was significantly predicted by age and presurgical scores on the Symptom Checklist-90-Revised Somatization subscale (Nagelkerke R-2 = 0.27, P < 0.001), whereas chronic pain disability was only predicted by presurgical Symptom Checklist-90-Revised Somatization scores (Nagelkerke R-2 = 0.29, P < 0.001). These findings demonstrate that presurgical distress over bodily sensations predicts greater chronic pain intensity and disability 6 months after cardiothoracic surgery and suggest that presurgical treatment to diminish such distress may prevent or minimize CPSP intensity and disability.

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