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Chronic postsurgical pain in Europe: An observational study
Dominique Fletcher1, Ulrike M Stamer, Esther Pogatzki-Zahn
1From the Department of Anaesthesiology Raymond Poincaré Hospital, Garches, APHP, Université Versailles St Quentin, Inserm 987, France (DF), Department of Anaesthesiology and Pain Medicine, Inselspital and Department of Clinical Research, University of Bern, Bern, Switzerland (UMS), Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster UKM, Munster (EP-Z), Department of Anaesthesiology, University Hospital, Jena, Germany (RZ, MK), Department of Anaesthesiology, Central University and Emergency Military Hospital, Bucharest, Romania (NVT), Department of Anaesthesiology and Pain Management, Hospital of Morges and University Hospital Center of Lausanne, Lausanne, Switzerland (CP), Department of Anaesthesia and Critical Care, University Hospitals of Würzburg, Würzburg (PK), Department of Biostatistics, Friedrich-Schiller-University, Jena, Germany (TL), and Clinical Trial Network, European Society of Anaesthesiology, Brussels, Belgium (euCPSP group) *Both Dominique Fletcher and Ulrike M. Stamer contributed equally to the writing of this article.
Chronic postsurgical pain (CPSP) affects 11.8% of patients 12 months after surgery. Key risk factors include preoperative pain, orthopedic procedures, and severe acute pain post-surgery.
Area of Science:
- Pain Medicine
- Surgical Outcomes
- Clinical Epidemiology
Background:
- Chronic postsurgical pain (CPSP) presents a significant clinical challenge.
- Prospective data on CPSP incidence, characteristics, and risk factors are crucial for effective management.
- The PAIN OUT registry facilitates multicenter data collection on postsurgical pain.
Purpose of the Study:
- To determine the incidence of moderate to severe CPSP at 12 months post-surgery.
- To identify risk factors associated with the development of CPSP.
- To evaluate the relationship between CPSP severity, neuropathic pain characteristics, and functional impairment.
Main Methods:
- A multicenter, prospective, observational trial involving 3,120 patients across 11 European countries.
- Pain outcomes assessed on postoperative day 1, and at 6 and 12 months using standardized questionnaires (e.g., Brief Pain Inventory, DN4).
- Multivariate analysis employed to identify independent risk factors for CPSP.
Main Results:
- The incidence of moderate to severe CPSP at 12 months was 11.8% (95% CI 9.7-13.9).
- Neuropathic pain signs were present in 35.4% and 57.1% of moderate and severe CPSP cases, respectively.
- Orthopaedic surgery, preoperative chronic pain, and severe acute pain (D1) were significant risk factors for CPSP.
Conclusions:
- Data collection for CPSP is feasible within the PAIN OUT registry.
- CPSP incidence is substantial, with significant functional impairment and neuropathic characteristics observed.
- Preoperative pain, surgical type (orthopaedic), and acute pain severity are key modifiable risk factors for CPSP.
