Ann Kristin Bjørnnes1,2, Monica Parry3, Irene Lie4,5, Morten Wang Fagerland6, Judy Watt-Watson7, Tone Rustøen8,9, Audun Stubhaug10,11, Marit Leegaard12,13. 1. Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway. ann-kristin.bjornnes@hioa.no. 2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. ann-kristin.bjornnes@hioa.no. 3. Nurse Practitioner Programs, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. 4. Division of Cardiovascular and Pulmonary Diseases, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway. 5. Ullevål/Center for Patient Centered Heart- and Lung Research, Oslo University Hospital, Oslo, Norway. 6. Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway. 7. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. 8. Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway. 9. Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway. 10. Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway. 11. Faculty of Medicine, University of Oslo, Oslo, Norway. 12. Faculty of Health Sciences, Institute of Nursing, Oslo, Norway. 13. Akershus University College of Applied Sciences, Oslo, Norway.
Abstract
AIMS AND OBJECTIVES: To compare the prevalence and severity of pain in men and women during the first year following cardiac surgery and to examine the predictors of persistent postoperative pain 12 months post surgery. BACKGROUND: Persistent pain has been documented after cardiac surgery, with limited evidence for differences between men and women. DESIGN: Prospective cohort study of patients in a randomised controlled trial (N = 416, 23% women) following cardiac surgery. METHODS: Secondary data analysis of data collected prior to surgery, across postoperative days 1-4, at two weeks, and at one, three, six and 12 months post surgery. The main outcome was worst pain intensity (Brief Pain Inventory-Short Form). RESULTS: Twenty-nine percent (97/339) of patients reported persistent postoperative pain at rest at 12 months that was worse in intensity and interference for women than for men. For both sexes, a more severe co-morbidity profile, lower education and postoperative pain at rest at one month post surgery were associated with an increased probability for persistent postoperative pain at 12 months. Women with more concerns about communicating pain and a lower intake of analgesics in the hospital had an increased probability of pain at 12 months. CONCLUSION: Sex differences in pain are present up to one year following cardiac surgery. Strategies for sex-targeted pain education and management pre- and post-surgery may lead to better pain outcomes. RELEVANCE TO CLINICAL PRACTICE: These results suggest that informing patients (particularly women) about the benefits of analgesic use following cardiac surgery may result in less pain over the first year post discharge.
RCT Entities:
AIMS AND OBJECTIVES: To compare the prevalence and severity of pain in men and women during the first year following cardiac surgery and to examine the predictors of persistent postoperative pain 12 months post surgery. BACKGROUND: Persistent pain has been documented after cardiac surgery, with limited evidence for differences between men and women. DESIGN: Prospective cohort study of patients in a randomised controlled trial (N = 416, 23% women) following cardiac surgery. METHODS: Secondary data analysis of data collected prior to surgery, across postoperative days 1-4, at two weeks, and at one, three, six and 12 months post surgery. The main outcome was worst pain intensity (Brief Pain Inventory-Short Form). RESULTS: Twenty-nine percent (97/339) of patients reported persistent postoperative pain at rest at 12 months that was worse in intensity and interference for women than for men. For both sexes, a more severe co-morbidity profile, lower education and postoperative pain at rest at one month post surgery were associated with an increased probability for persistent postoperative pain at 12 months. Women with more concerns about communicating pain and a lower intake of analgesics in the hospital had an increased probability of pain at 12 months. CONCLUSION: Sex differences in pain are present up to one year following cardiac surgery. Strategies for sex-targeted pain education and management pre- and post-surgery may lead to better pain outcomes. RELEVANCE TO CLINICAL PRACTICE: These results suggest that informing patients (particularly women) about the benefits of analgesic use following cardiac surgery may result in less pain over the first year post discharge.
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