Kristina Radinovic1, Zoka Milan2, Ljiljana Markovic-Denic3, Emilija Dubljanin-Raspopovic4, Bojan Jovanovic5, Vesna Bumbasirevic5. 1. Centre for Anaesthesiology, Clinical Centre of Serbia, Belgrade, Serbia. Electronic address: kris.radinovic@gmail.com. 2. King's College Hospital, London, United Kingdom. 3. University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia. 4. Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia. 5. Centre for Anaesthesiology, Clinical Centre of Serbia, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia.
Abstract
INTRODUCTION: The aim of this study was to identify risk factors for severe postoperative pain immediately after hip-fracture surgery. PATIENTS AND METHODS: Three hundred forty-four elderly patients with an acute hip fracture were admitted to the hospital during a 12-months period. All patients who entered the study answered a structured questionnaire to assess demographic characteristics, previous diseases, drug use, previous surgery, and level of education. Physical status was assessed through the American Society of Anesthesiologists' preoperative risk classification, cognitive status using the Short Portable Mental Status Questionnaire, and depression using the Geriatric Depression Scale. The presence of preoperative delirium using the Confusion Assessment Method was assessed during day and night shifts until surgery. Pain was measured using a numeric rating scale (NRS). An NRS ≥ 7 one hour after surgery indicated severe pain. RESULTS: Patients with elementary-level education (8 yr in school) presented a higher risk for immediate severe postoperative pain than university-educated patients (> 12 yr in school) (P < 0.05). Higher cognitive function was associated with higher postoperative pain (P < 0.01). Patients with symptoms of depression and patients with preoperative delirium presented a higher risk for severe pain (P < 0.05, P < 0.01, respectively). Multivariate analysis showed that depression and a low level of education were independent predictors of severe pain immediately after surgery. CONCLUSION: Depression and lower levels of education were independent predictors of immediate severe pain following hip-fracture surgery. These predictors could be clinically used to stratify analgesic risk in elderly patients for more aggressive pain treatment immediately after surgery.
INTRODUCTION: The aim of this study was to identify risk factors for severe postoperative pain immediately after hip-fracture surgery. PATIENTS AND METHODS: Three hundred forty-four elderly patients with an acute hip fracture were admitted to the hospital during a 12-months period. All patients who entered the study answered a structured questionnaire to assess demographic characteristics, previous diseases, drug use, previous surgery, and level of education. Physical status was assessed through the American Society of Anesthesiologists' preoperative risk classification, cognitive status using the Short Portable Mental Status Questionnaire, and depression using the Geriatric Depression Scale. The presence of preoperative delirium using the Confusion Assessment Method was assessed during day and night shifts until surgery. Pain was measured using a numeric rating scale (NRS). An NRS ≥ 7 one hour after surgery indicated severe pain. RESULTS:Patients with elementary-level education (8 yr in school) presented a higher risk for immediate severe postoperative pain than university-educated patients (> 12 yr in school) (P < 0.05). Higher cognitive function was associated with higher postoperative pain (P < 0.01). Patients with symptoms of depression and patients with preoperative delirium presented a higher risk for severe pain (P < 0.05, P < 0.01, respectively). Multivariate analysis showed that depression and a low level of education were independent predictors of severe pain immediately after surgery. CONCLUSION:Depression and lower levels of education were independent predictors of immediate severe pain following hip-fracture surgery. These predictors could be clinically used to stratify analgesic risk in elderly patients for more aggressive pain treatment immediately after surgery.
Authors: K J Sheehan; E M Guerrero; D Tainter; B Dial; R Milton-Cole; J A Blair; J Alexander; P Swamy; L Kuramoto; P Guy; J P Bettger; B Sobolev Journal: Osteoporos Int Date: 2019-04-29 Impact factor: 4.507
Authors: Michael M H Yang; Rebecca L Hartley; Alexander A Leung; Paul E Ronksley; Nathalie Jetté; Steven Casha; Jay Riva-Cambrin Journal: BMJ Open Date: 2019-04-01 Impact factor: 2.692
Authors: Carolina L Schiavo; Rogério B Borges; Stela M J Castro; Anelise S Wolmeister; Andressa de Souza; Otávio R S Martins; Gabriela S Galvão; Kahio C K Nazario; Fabian J Nickel; Wolnei Caumo; Luciana C Stefani Journal: PLoS One Date: 2022-02-16 Impact factor: 3.240