Pediatric Pain Screening Tool: A Simple 9-Item Questionnaire Predicts Functional and Chronic Postsurgical Pain...

Area of Science:

• Pediatric surgery
• Pain management
• Clinical assessment

Background:

• Chronic postsurgical pain (CPSP) and impaired function are significant concerns following pediatric surgeries.
• Currently, reliable and clinic-friendly screening tools for CPSP risk are lacking.
• Early identification of at-risk individuals is crucial for timely intervention.

Purpose of the Study:

• To evaluate the Pediatric Pain Screening Tool (PPST), a 9-item questionnaire, as a preoperative screening tool.
• To assess PPST's ability to identify patients at higher risk for CPSP and poor function after spine fusion and Nuss procedures.
• To determine the correlation between PPST scores and established risk factors for CPSP.

Main Methods:

• A prospective, observational study involving 109 pediatric patients undergoing spine fusion or Nuss procedures.
• The Pediatric Pain Screening Tool (PPST) was administered preoperatively.
• Correlation analyses were performed between PPST scores and various preoperative risk factors (pain, anxiety, depression, pain interference, quality of life, insomnia).
• Postoperative pain and function (FDI, PedsQL) were assessed at 6 and 12 months.
• Receiver Operating Characteristic (ROC) analysis was used to determine the optimal PPST cutoff for CPSP risk.

Main Results:

• The incidence of CPSP was 34.86%.
• PPST demonstrated good test-retest reliability (ICC = 0.68).
• Preoperative PPST scores positively correlated with preoperative pain, anxiety sensitivity, pain interference, depression, and insomnia severity, and negatively with quality of life.
• Higher preoperative PPST scores were associated with increased risk of CPSP and poorer functional outcomes at 6 and 12 months.
• An optimal PPST cutoff score of 2 yielded 63.9% sensitivity and 64.7% specificity for predicting CPSP.

Conclusions:

• The Pediatric Pain Screening Tool (PPST) is a reliable and valid preoperative screening tool for identifying children at risk of developing chronic postsurgical pain and functional impairment after spine and pectus surgeries.
• The PPST allows for risk stratification, enabling the development of targeted, non-pharmacological interventions for high-risk individuals.
• Further validation in larger and diverse pediatric surgical populations is recommended.