Pain-related functional interference in patients with chronic neuropathic postsurgical pain: an analysis of registry data
| Autor: | Ulrike M. Stamer, Michaela Ehrler, Winfried Meissner, Dominique Fletcher, Thomas R. Lehmann |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Activities of Daily Living Health care Humans Medicine In patient Registries 610 Medicine & health Pain Measurement Pain Postoperative business.industry Postsurgical pain Middle Aged Anesthesiology and Pain Medicine Neurology Functional interference Physical therapy Neuralgia Female Registry data Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Pain. 160:1856-1865 |
| ISSN: | 1872-6623 0304-3959 |
| DOI: | 10.1097/j.pain.0000000000001560 |
| Popis: | Although chronic postsurgical pain (CPSP) is a major health care problem, pain-related functional interference has rarely been investigated. Using the PAIN OUT registry, we evaluated patients' pain-related outcomes on the first postoperative day, and their pain-related interference with daily living (Brief Pain Inventory) and neuropathic symptoms (DN4: douleur neuropathique en 4 questions) at 6 months after surgery. Endpoints were pain interference total scores (PITS) and their association with pain and DN4 scores. Furthermore, possible risk factors associated with impaired function at M6 were analyzed by ordinal regression analysis with PITS groups (no to mild, moderate, and severe interference) as a dependent three-stage factor. Odds ratios with 95% confidence intervals were calculated. Of 2322 patients, 15.3% reported CPSP with an average pain score ≥3 (numeric rating scale 0-10). Risk for a higher PITS group increased by 190% (odds ratio [95% confidence interval]: 2.9 [2.7-3.2]; P0.001) in patients with CPSP, compared to without CPSP. A positive DN4 independently increased risk by 29% (1.3 [1.12-1.45]; P0.001). Preexisting chronic pain (3.6 [2.6-5.1]; P0.001), time spent in severe acute pain (2.9 [1.3-6.4]; P = 0.008), neurosurgical back surgery in males (3.6 [1.7-7.6]; P0.001), and orthopedic surgery in females (1.7 [1.0-3.0]; P = 0.036) were the variables with strongest association with PITS. Pain interference total scores might provide more precise information about patients' outcomes than pain scores only. Because neuropathic symptoms increase PITS, a suitable instrument for their routine assessment should be defined. |
| Databáze: | OpenAIRE |
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