Prevalence and predictors of persistent post-surgical pain 12 months after thoracotomy

Abstract

Background: Persistent post-surgical pain is recognised as a major problem. Prevalence after different surgical procedures has been reported to range from 5% up to 85%. Limb amputation and thoracotomy have the highest reported prevalence. Prediction of persistent post-surgical pain has over the last decade caught atten- tion. Several factors have been investigated, but in-depth knowl- edge is still scarce. The purpose of this study was to investigate the prevalence of persistent post-surgical pain, and predictive fac- tors for persistent post-surgical pain 12 months after thoracotomy. Methods: A prospective longitudinal study was conducted. One- hundred and seventy patients were recruited before scheduled thoracotomy, and asked to answer a questionnaire. One-hundred and six patients completed the same questionnaire at 12-month follow-up. Regression analysis was performed to explore vari- ables assumed predictive of persistent post-surgical pain. Results: One-hundred and six patients (62%) filled out the questionnaire at both time points. Preoperative, 34% reported muscle-skeletal related chronic pain. At 12-month follow-up, 50% of the patients reported persistent post-surgical pain. Of the vari- ables explored in the logistic regression model, only preoperative pain ( P < 0.001) and dispositional optimism ( P = 0.04) were sta- tistically significant. In this study, preoperative pain was a pre- dominant predictor for persistent postoperative pain (OR 6.97, CI 2.40 – 20.21), while dispositional optimism (OR 0.36, CI 0.14 – 0.96) seem to have protective properties. Conclusion: Our results show that preoperative pain is a pre- dominant predictor of future pain. This implies that patients pre- senting with a chronic pain condition prior to surgery should be assessed thoroughly preoperatively and have an individually tailored analgesic regimen.