Incidence of Chronic Postsurgical Pain (CPSP) after General Surgery
| Autor: | Astrid Althaus, Edmund Neugebauer, Petra Hoederath, Christian Simanski, Rolf Lefering, Kerry W. Kreutz, Sascha Hoederath, Carolina Pape-Köhler |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
education.field_of_study business.industry General surgery Trauma center Population Chronic pain General Medicine Numeric Pain Scale medicine.disease Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Colon surgery Orthopedic surgery medicine Abdomen Neurology (clinical) Prospective cohort study education business |
| Zdroj: | Pain Medicine. 15:1222-1229 |
| ISSN: | 1526-2375 |
| DOI: | 10.1111/pme.12434 |
| Popis: | Objective This study investigated the incidence and determinants of chronic postsurgical pain (CPSP) in a general surgical patient population. Design This is a prospective cross-sectional study at a university-affiliated clinic/level 1 trauma center. Patients were followed at least 1 year postoperatively. By surgical discipline, procedures were 50% orthopedic/trauma, 33% general (abdominal/visceral), and 17% vascular. Setting All patients admitted during one year (N = 3020) were eligible. Exclusion criteria were cognitive impairment, communication/language barrier, nonoperative treatment, and refusal to participate. A CPSP questionnaire was completed. Step-by-step analysis followed with a 2nd questionnaire to detect CPSP with numeric rating scale (NRS) pain intensity ≥3. Finally, individual follow-up examinations were performed. Results 911 patients responded (30.2%). 522 complained of pain intensity ≥3 on NRS (scale 0–10). The second step identified 214 patients with chronic pain (NRS ≥3, mean 29 months postoperatively). On final examination, 83 CPSP patients (14.8%) were identified. By surgical discipline, 28% were general, 15% vascular, and 57% trauma/orthopedic surgery. Most oftenly cited pain sites were joint (49.4%), incisional/scar (37.7%), and nerve pain (33.7%). By procedure, patients underwent pelvic surgery, colon surgery, laparoscopies, inguinal herniorrhaphies, arthroscopies, and hardware extractions. All patients in the “laborer” and “unemployed” categories reported chronic pain. Conclusion Bias due to study design and/or heterogeneity of patients is possible, but there was a high CPSP rate after 2 years both generally and particularly in orthopedic/trauma (57%) patients. Both “major” and “minor” surgical procedures led to CPSP. |
| Databáze: | OpenAIRE |
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