Chronic pain following thoracotomy for lung surgeries: It's risk factors, prevalence, and impact on quality of life - A retrospective study

Abstract

Background and Aims: Chronic post thoracotomy pain (CPTP) is a nagging complication and can affect quality of life (QOL). Studies conducted across globe have found a wide variability in the risk factors predisposing to chronic pain following thoracotomy. As no study on CPTP is available from India, we aim to detect the prevalence of CPTP, assess the predisposing factors implicated in its causation and study the impact of CPTP on QOL. Methods: After obtaining clearance from Institutional ethics committee, medical records of patients who underwent open posterolateral thoracotomy between January 2012 and December 2015 were reviewed. Data on perioperative variables, address, and contact number were collected from the patient records. All patients were mailed the Telugu translation of medical outcome study short form -36(MOS-SF-36) QOL questionnaire and were contacted telephonically to enquire about presence of CPTP and QOL. A univariate analysis was done to assess factors associated with CPTP and a multivariate logistic regression analysis was done subsequently to identify independent risk factors of CPTP. QOL indices were compared between those patients who suffered from CPTP and those who did not. Results: The prevalence of pain in our study was 40.86% (85/208). The factors implicated in the causation of CPTP were diabetes mellitus, preoperative pain, rib resection, and duration of chest tube drainage with odds ratio of 9.8, 2.6, 6.7, and 1.03, respectively. The health-related QOL showed poor scores in all domains in patients suffering from CPTP. Conclusion: The prevalence of CPTP was high. It significantly impacts health-related QOL.

Incidence and Influencing Factors of Chronic Postthoracotomy Pain in Lung Tumor Patients

“…Bayman and Brennan [ 5 ] reported that more than half of patients suffered CPTP; thus, it seriously influenced community health. Previous studies [ 6 – 10 ] have found that CPTP was influenced by age, sex, diabetes, properties of tumor, type of surgery, duration of chest tube drainage, and so on; nevertheless, these influencing factors relatively lack repeatability of studies. Although CPTP is one of the great burdens in community health, the mechanism of CPTP is still unknown; hence, the tracing of the predictors or risk factors of CPTP is particularly important for prevention and prediction.…”

Prognostic factors for chronic post-surgical pain after lung or pleural surgery: a protocol for a systematic review and meta-analysis

“…to be less painful compared with a regular thoracotomy because it is less invasive, however, incidence and severity of CPSP have been reported to be similar. 8 CPSP after thoracic surgery has been associated with a lower overall quality of life, [9][10][11][12][13] and chronic pain is associated with an increased utilisation of healthcare, increased absenteeism and decreased work-related effectiveness. [14][15][16] The direct health-related costs of chronic pain have been reported to be US$11 846 annually, 17 and the indirect work-related costs have been reported to be US$29 617 annually.…”

A tripartite challenge of orphaned manuscripts, heedless writing and reluctant reviewing...... revamping the editing process!

“…Systematic reviews, meta-analysis and randomised controlled trials occupy the highest position in evidence-based medicine, but in spite of this academic awareness, authors are nowadays resorting to quick research recipes like retrospective studies and online surveys. [ 3 ] The small number of meta-analyses[ 4 5 6 ] and large number of surveys[ 7 8 9 10 11 ] and retrospective studies[ 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 ] published in the IJA in the last few years are an evidence to this. The commonly known inverse ratio of quantity to quality has also been equally observed at IJA with this enhanced submission process.…”