Presurgical distress about bodily sensations predicts chronic postsurgical pain intensity and disability 6 months after cardiothoracic surgery

Abstract

Chronic postsurgical pain (CPSP) and disability after cardiothoracic surgery are highly prevalent and difficult to treat. Researchers have explored a variety of presurgical risk factors for CPSP and disability after cardiothoracic surgery, including one study that examined distress from bodily sensations. The current prospective, longitudinal study sought to extend previous research by investigating presurgical distress about bodily sensations as a risk factor for CPSP and disability after cardiothoracic surgery while controlling for several other potential psychosocial predictors. Participants included 543 adults undergoing nonemergency cardiac or thoracic surgery who were followed over 6 months postsurgically. Before surgery, participants completed demographic, clinical, and psychological questionnaires. Six months after surgery, participants reported the intensity of CPSP on a 0 to 10 numeric rating scale and pain disability, measured by the Pain Disability Index. Multinomial logistic regression analyses were conducted to evaluate the degree to which presurgical measures predicted pain outcomes 6 months after surgery. The results showed that CPSP intensity was significantly predicted by age and presurgical scores on the Symptom Checklist-90-Revised Somatization subscale (Nagelkerke R 2 5 0.27, P , 0.001), whereas chronic pain disability was only predicted by presurgical Symptom Checklist-90-Revised Somatization scores (Nagelkerke R 2 5 0.29, P , 0.001). These findings demonstrate that presurgical distress over bodily sensations predicts greater chronic pain intensity and disability 6 months after cardiothoracic surgery and suggest that presurgical treatment to diminish such distress may prevent or minimize CPSP intensity and disability.

Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study

“…Consequently, this generates a huge economic burden and large consumption of medical resources. 18,19 It is increasingly recognized that good management of CPSP will definitely improve postoperative recovery and clinical outcomes, 11,20,21 which should draw the attention of anaesthesiologists.…”

Change in perioperative neutrophil-lymphocyte ratio as a potential predictive biomarker for chronic postsurgical pain and quality of life: an ambispective observational cohort study

“…Accurate prediction of CPSP is a pressing prerequisite for CPSP prevention and intervention. Some studies have proposed predictive models for CPSP ( 5 , 13 , 17 – 20 ), but too many variables and their subjective nature make them less operable in practice.…”

“…It occurs in up to 85% of patients with amputation, 30-50% after breast surgery, and approximately 10% after inguinal hernia repairs (2), which means that more than 32 million additional people globally suffer from long-lasting pain every year (3). Owing to discomfort, distress, disability, increased medical burden, and opioid abuse, CPSP has become a major public health problem (4)(5)(6). It is anticipated that identifying the potential early predictive factors of CPSP would be helpful for understanding and exploring the underlying mechanisms and developing better therapeutic strategies.…”