TY - JOUR
T1 - Effects of patient and surgery characteristics on persistent postoperative pain
T2 - A mediation analysis
AU - Temporal Postoperative Pain Signatures (TEMPOS) Group CEP
AU - Mi, Xinlei
AU - Zou, Baiming
AU - Rashidi, Parisa
AU - Baharloo, Raheleh
AU - Fillingim, Roger B.
AU - Wallace, Margaret R.
AU - Crispen, Paul L.
AU - Parvataneni, Hari K.
AU - Prieto, Hernan A.
AU - Gray, Chancellor F.
AU - Machuca, Tiago N.
AU - Hughes, Steven J.
AU - Murad, Gregory J.A.
AU - Thomas, Elizabeth
AU - Iqbal, Atif
AU - Tighe, Patrick J.
N1 - Funding Information:
Conflicts of Interest and Sources of Funding: This work was supported by NIH R01 GM114290 and the Donn M. Dennis MD Professorship in Anesthetic Innovation (P.J.T.). The authors declare no conflicts of interest.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Objective: Acute postoperative pain intensity is associated with persistent postsurgical pain risk. However, it remains unclear whether acute postoperative pain intensity mediates the relationship between clinical factors and persistent pain. Methods: Subjects from a mixed surgical population completed the Brief Pain Inventory and pain catastrophizing scale before surgery, and the Brief Pain Inventory daily after surgery for 7 days and at 30 and 90 days after surgery. We considered mediation models using the mean of the worst pain intensities collected daily on each of postoperative days (PODs) 1 to 7 against outcomes of worst pain intensity at the surgical site endpoints reflecting persistent postsurgical pain (POD 90) and subacute pain (POD 30). Results: The analyzed cohort included 284 subjects for the POD 90 outcome. For every unit increase of maximum acute postoperative pain intensity through PODs 1 to 7, there was a statistically significant increase of mean POD 90 pain intensity by 0.287 after controlling for confounding effects. The effects of female vs. male sex (m=0.212, P=0.034), pancreatic/biliary vs. colorectal surgery (m=0.459, P=0.012), thoracic cardiovascular vs. colorectal surgery (m=0.31, P=0.038), every minute increase of anesthesia time (m=0.001, P=0.038), every unit increase of preoperative average pain score (m=0.012, P=0.015), and every unit increase of catastrophizing (m=0.044, P=0.042) on POD 90 pain intensity were mediated through acute PODs 1 to 7 postoperative pain intensity. Discussion: Our results suggest the mediating relationship of acute postoperative pain on persistent postsurgical pain may be predicated on select patient and surgical factors.
AB - Objective: Acute postoperative pain intensity is associated with persistent postsurgical pain risk. However, it remains unclear whether acute postoperative pain intensity mediates the relationship between clinical factors and persistent pain. Methods: Subjects from a mixed surgical population completed the Brief Pain Inventory and pain catastrophizing scale before surgery, and the Brief Pain Inventory daily after surgery for 7 days and at 30 and 90 days after surgery. We considered mediation models using the mean of the worst pain intensities collected daily on each of postoperative days (PODs) 1 to 7 against outcomes of worst pain intensity at the surgical site endpoints reflecting persistent postsurgical pain (POD 90) and subacute pain (POD 30). Results: The analyzed cohort included 284 subjects for the POD 90 outcome. For every unit increase of maximum acute postoperative pain intensity through PODs 1 to 7, there was a statistically significant increase of mean POD 90 pain intensity by 0.287 after controlling for confounding effects. The effects of female vs. male sex (m=0.212, P=0.034), pancreatic/biliary vs. colorectal surgery (m=0.459, P=0.012), thoracic cardiovascular vs. colorectal surgery (m=0.31, P=0.038), every minute increase of anesthesia time (m=0.001, P=0.038), every unit increase of preoperative average pain score (m=0.012, P=0.015), and every unit increase of catastrophizing (m=0.044, P=0.042) on POD 90 pain intensity were mediated through acute PODs 1 to 7 postoperative pain intensity. Discussion: Our results suggest the mediating relationship of acute postoperative pain on persistent postsurgical pain may be predicated on select patient and surgical factors.
KW - Acute pain
KW - Chronic pain
KW - Mediation analysis
KW - Perioperative
KW - Surgery
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U2 - 10.1097/AJP.0000000000000979
DO - 10.1097/AJP.0000000000000979
M3 - Article
C2 - 34475340
AN - SCOPUS:85116369877
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
SN - 0749-8047
ER -