Pain severity scale: A methodology for classifying postoperative pain severity by surgical procedure

Area of Science:

• Pain Management
• Surgical Outcomes
• Health Informatics

Background:

• Acute postoperative pain is a common challenge, with severe cases leading to complications.
• Opioid use for pain management carries risks of adverse outcomes.
• Developing objective tools for pain assessment is crucial.

Purpose of the Study:

• To develop a novel Postoperative Pain Severity Scale (PSS).
• To categorize surgical procedures based on pain severity and opioid requirements.
• To improve the management of postoperative pain.

Main Methods:

• Retrospective analysis of the Veterans Administration Surgical Quality Improvement Project (VASQIP) database (2010-2020).
• Utilized Common Procedural Terminology (CPT) codes for 165,321 surgical procedures.
• Applied K-means clustering to group surgeries by pain scores and opioid data.

Main Results:

• K-means clustering identified optimal grouping strategies (3 and 5 groups).
• The developed Pain Severity Scale (PSS) effectively categorized procedures by increasing pain and opioid use.
• A 5-group PSS demonstrated accuracy in reflecting typical postoperative pain experiences.

Conclusions:

• The Pain Severity Scale (PSS) distinguishes typical postoperative pain across diverse procedures.
• PSS utilizes subjective and objective clinical data for pain assessment.
• The PSS can support research and clinical decision-making tools for pain management.