Somatic and psychologic predictors of long-term unfavorable outcome after surgical intervention
| Autor: | Fons Kessels, Marco A. E. Marcus, Madelon L. Peters, Micha Sommer, Erik Heineman, Johan W.S. Vlaeyen, Janneke M. de Rijke, Jacob Patijn, Maarten van Kleef |
|---|---|
| Přispěvatelé: | Dep.Medische en Klin. Experimentele Psy., MUMC+: KIO Kemta (9), Algemene Heelkunde, Clinical Psychological Science, Anesthesiologie, RS: FPN CPS I, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: NUTRIM - R2 - Gut-liver homeostasis |
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Activities of daily living Time Factors Quality of life Medicine Humans Risk factor Pain Postoperative Principal Component Analysis business.industry Chronic pain Fear Recovery of Function Original Articles Middle Aged medicine.disease Neuroticism Logistic Models Treatment Outcome Surgical Procedures Operative Physical therapy Quality of Life Anxiety Surgery Pain catastrophizing medicine.symptom business Abdominal surgery |
| Zdroj: | Annals of Surgery, 245(3), 487-494. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/01.sla.0000245495.79781.65 |
| Popis: | Recent studies have indicated that chronic pain after surgical intervention is more common than previously assumed. Prevalence rates of chronic postoperative pain vary across studies and type of procedures, ranging from approximately 10% for inguinal hernia operations up to 30% to 50% for cardiac surgery.1–12 A substantial percentage of patients report that this pain interferes with daily activities and leads to physical impairments.1,5,8–10 Nerve injury may be one of the causes of chronic postoperative pain, but not all postoperative pain is of neuropathic origin.4,6 Another potential cause of sustained pain is neuroplastic change in the central nervous system induced by high-intensity pain in the first days following surgery.13 Several studies found severe acute postoperative pain to be a risk factor for chronic pain.2,9,11,14 Other identified risk factors for sustained postoperative pain are younger age,4,6,10 female gender,15,16 and pain before the operation.2,4,10 Psychologic factors have also been proposed to influence postoperative pain. Important determinants of acute postoperative pain intensity appear to be preoperative anxiety and catastrophizing (ie, exaggerated negative beliefs) about pain.17–22 However, whether anxiety and catastrophizing also increase the risk of developing chronic postoperative pain remains to be determined. In a review of the literature on predictive factors for chronic postoperative pain, Perkins and Kehlet2 conclude that the only reproducible psychologic factor contributing to chronicity is neuroticism. Psychologic variables may also affect functional recovery after surgery. Catastrophizing about pain was negatively associated and optimism and self-efficacy were positively associated with the speed of functional recovery after various types of surgical interventions.23–27 Long-term effects of psychologic variables on physical disability and well-being have also been reported.16,25,28,29 For the present study, preoperative somatic and psychologic variables and acute postoperative pain were tested as predictors of pain, functional limitations, global perceived recovery, and health-related quality of life at 6 months follow-up in patients undergoing various surgical interventions. By combining somatic and psychologic predictors in a single study the relative contribution of a certain variable after controlling for other variables can be established. Moreover, multiple long-term outcome variables are included allowing assessment of the possible differential predictive power of somatic and psychologic factors for different outcomes. |
| Databáze: | OpenAIRE |
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