Preoperative frailty predicts postoperative pain after total knee arthroplasty in older patients: a prospective observational study.

Autor: Jin, Yinan, Tang, Suhong, Wang, Wenwen, Zhang, Wei, Hou, Yunfan, Jiao, Yang, Hou, Bailing, Ma, Zhengliang
Zdroj: European Geriatric Medicine; Jun2024, Vol. 15 Issue 3, p657-665, 9p
Abstrakt: Key summary points: Aim: Total knee arthroplasty (TKA) is an important therapy for OA, but control of postoperative pain is a clinical challenge. We assumed that frailty could predict post-surgical pain after TKA, especially in older patients. Findings: Preoperative frailty in older patients is an important risk factor for both acute and chronic pain after TKA, suggesting that frailty assessment should become a necessary procedure before operation, especially in older patients. Message: As a risk factor for post-surgical pain after TKA, timely intervention for preoperative frailty may be able to reduce the incidence of pain in older patients Purpose: Frailty is reportedly associated with postoperative adverse outcomes and may increase the risk of post-surgical pain. Our study aimed to explore whether frailty was an independent risk factor for pain after total knee arthroplasty (TKA) in older patients. Methods: Included in this prospective observational study were patients aged 65 or older who underwent primary TKA. Frailty of the patients was assessed before surgery using the comprehensive geriatric assessment-frailty index and pain was evaluated before and after surgery using the Numerical Rating Scale. Results: Of the 164 patients including 125 females with a mean age of 71.4 ± 4.6 years, 51 patients were identified as being frail. Patients with chronic post-surgical pain had a significantly higher frailty index than those without chronic post-surgical pain, which was the same in patients with acute post-surgical pain. After adjusting for other confounding factors, frailty was shown to be an independent risk factor for both acute (OR: 13.23, 95% CI 3.73–46.93, P < 0.001) and chronic post-surgical pain (OR: 4.24, 95% CI 1.29–14.00, P = 0.02). The area under the receiver operating characteristic curve for frailty predicting chronic post-surgical pain was 0.73 (P < 0.001, 95% CI 0.65–0.81). Conclusions: Our findings demonstrated that preoperative frailty in older patients was a predictor of acute and chronic post-surgical pain after TKA, suggesting that frailty assessment should become a necessary procedure before operations, especially in older patients. [ABSTRACT FROM AUTHOR]
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