OBJECTIVES: Our aim in this pilot study was to identify potential predictors of chronic post-surgical pain (CPSP) and other outcomes to consider for inclusion in future prospective studies of CPSP following abdominal gastrointestinal surgery. METHODS: We followed 76 surgical patients during this prospective single-centre cohort study. Pain characteristics, health-related quality of life (HRQOL), and healthcare utilization were assessed preoperatively, at six weeks postoperatively, and at six months postoperatively. Statistical analyses included descriptive statistics and repeated measures analysis of variance. RESULTS: Prior to surgery, 42% of patients reported no pain, 18% reported remote pain, and 33% reported pain at the surgical site. Six months after surgery, 29% of patients with preoperative remote pain and 35% of patients with preoperative pain at the surgical site reported CPSP. Pain-related interference declined from the preoperative to postoperative period; however, six months after surgery almost one-third of participants continued to report pain-related interference with mood (28%), sleep (30%), and enjoyment of life (30%). Consistent with studies of other surgical procedures, measures of anxiety and depression were associated with an increased risk of CPSP. During the six months following surgery, 12% of patients visited the Emergency Department, 15% visited non-traditional providers, and 9.2% visited a walk-in clinic for pain. Compared with Canadian norms, HRQOL was poorer in all domains preoperatively, in all domains but mental health six weeks postoperatively, and in most domains six months postoperatively. CONCLUSION: This feasibility study provides a template for future studies of CPSP following gastrointestinal surgery. Results suggest a substantial burden of persistent pain, healthcare utilization, and decreased HRQOL. Larger-scale studies that are similarly designed will serve to identify predictors of CPSP in this surgical population.
OBJECTIVES: Our aim in this pilot study was to identify potential predictors of chronic post-surgical pain (CPSP) and other outcomes to consider for inclusion in future prospective studies of CPSP following abdominal gastrointestinal surgery. METHODS: We followed 76 surgical patients during this prospective single-centre cohort study. Pain characteristics, health-related quality of life (HRQOL), and healthcare utilization were assessed preoperatively, at six weeks postoperatively, and at six months postoperatively. Statistical analyses included descriptive statistics and repeated measures analysis of variance. RESULTS: Prior to surgery, 42% of patients reported no pain, 18% reported remote pain, and 33% reported pain at the surgical site. Six months after surgery, 29% of patients with preoperative remote pain and 35% of patients with preoperative pain at the surgical site reported CPSP. Pain-related interference declined from the preoperative to postoperative period; however, six months after surgery almost one-third of participants continued to report pain-related interference with mood (28%), sleep (30%), and enjoyment of life (30%). Consistent with studies of other surgical procedures, measures of anxiety and depression were associated with an increased risk of CPSP. During the six months following surgery, 12% of patients visited the Emergency Department, 15% visited non-traditional providers, and 9.2% visited a walk-in clinic for pain. Compared with Canadian norms, HRQOL was poorer in all domains preoperatively, in all domains but mental health six weeks postoperatively, and in most domains six months postoperatively. CONCLUSION: This feasibility study provides a template for future studies of CPSP following gastrointestinal surgery. Results suggest a substantial burden of persistent pain, healthcare utilization, and decreased HRQOL. Larger-scale studies that are similarly designed will serve to identify predictors of CPSP in this surgical population.
Authors: Moira H D Bruintjes; Esmee V van Helden; Marjan de Vries; Lieke Wirken; Andrea W M Evers; Henriët van Middendorp; Heinrich Kloke; Frank C H d'Ancona; Johan F Langenhuijsen; Monique A H Steegers; Michiel C Warlé Journal: Am J Transplant Date: 2019-04-11 Impact factor: 8.086
Authors: Sarah Walker; Wilma M Hopman; Meg E Carley; Elizabeth G Mann; Elizabeth G VanDenKerkhof Journal: Pain Res Manag Date: 2016-03-29 Impact factor: 3.037
Authors: Joel Katz; Aliza Weinrib; Samantha R Fashler; Rita Katznelzon; Bansi R Shah; Salima Sj Ladak; Jiao Jiang; Qing Li; Kayla McMillan; Daniel Santa Mina; Kirsten Wentlandt; Karen McRae; Diana Tamir; Sheldon Lyn; Marc de Perrot; Vivek Rao; David Grant; Graham Roche-Nagle; Sean P Cleary; Stefan Op Hofer; Ralph Gilbert; Duminda Wijeysundera; Paul Ritvo; Tahir Janmohamed; Gerald O'Leary; Hance Clarke Journal: J Pain Res Date: 2015-10-12 Impact factor: 3.133