OBJECTIVES: Persistent postoperative pain is reported by 30% to 50% of patients following breast cancer surgery. Studies testing preventive measures, however, have so far failed to produce consistent positive results. If preventive measures could be targeted to a subgroup of patients at high risk of persistent pain, positive results would be more likely. Our aim was to develop a simple risk score predicting persistent pain after breast cancer surgery. MATERIALS AND METHODS: In a prospective observational cohort study, we tested the predictive ability of a 4 simple items score for persistent pain in 200 patients scheduled for breast cancer surgery. A multivariable logistic regression model was created for the outcome of clinically important pain at 4 months. RESULTS: On the basis of literature review and univariable analysis of our data, 4 parameters were selected: preoperative pain at the surgical site, history of depression, age below 50 years and expected pain of high intensity (>6/10). Points for the score are based on the coefficients of the logistic regression model. A total score ≥2 points/5 predicts a risk of developing clinically important pain at 4 months >30%, with an area under the curve-receiver operating characteristic of 0.81. DISCUSSION: We studied known risk factors for persistent pain in patients scheduled for breast cancer surgery and constructed a preoperative risk score simple enough to select high-risk patients in future prevention studies.
OBJECTIVES: Persistent postoperative pain is reported by 30% to 50% of patients following breast cancer surgery. Studies testing preventive measures, however, have so far failed to produce consistent positive results. If preventive measures could be targeted to a subgroup of patients at high risk of persistent pain, positive results would be more likely. Our aim was to develop a simple risk score predicting persistent pain after breast cancer surgery. MATERIALS AND METHODS: In a prospective observational cohort study, we tested the predictive ability of a 4 simple items score for persistent pain in 200 patients scheduled for breast cancer surgery. A multivariable logistic regression model was created for the outcome of clinically important pain at 4 months. RESULTS: On the basis of literature review and univariable analysis of our data, 4 parameters were selected: preoperative pain at the surgical site, history of depression, age below 50 years and expected pain of high intensity (>6/10). Points for the score are based on the coefficients of the logistic regression model. A total score ≥2 points/5 predicts a risk of developing clinically important pain at 4 months >30%, with an area under the curve-receiver operating characteristic of 0.81. DISCUSSION: We studied known risk factors for persistent pain in patients scheduled for breast cancer surgery and constructed a preoperative risk score simple enough to select high-risk patients in future prevention studies.
Authors: Francesca Luzzati; Emanuele Maria Giusti; Gennaro Maria Scotto; Giuseppe Perrucchini; Luca Cannavò; Gianluca Castelnuovo; Andrea Colonna Cottini Journal: Support Care Cancer Date: 2019-07-01 Impact factor: 3.603
Authors: Marium M Raza; Ruth Zaslansky; Debra B Gordon; Jeanne M Wildisen; Marcus Komann; Ulrike M Stamer; Dale J Langford Journal: J Clin Med Date: 2021-04-27 Impact factor: 4.241