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Prevalence and Risk Factors for Chronic Postsurgical Pain After Thoracic Surgery: A Prospective Cohort Study.

James S Khan1, Elad Dana2, Maggie Z X Xiao1

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Chronic postsurgical pain (CPSP) affects about one-third of patients three months after thoracic surgery. Preoperative anxiety, depression, and acute pain are key risk factors for developing CPSP.

Keywords:
chronic postsurgical painneuropathicrisk factorsthoracic surgery

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Area of Science:

  • Thoracic Surgery
  • Pain Medicine
  • Surgical Outcomes

Background:

  • Thoracic surgery has a high incidence of chronic postsurgical pain (CPSP).
  • CPSP significantly impacts patients' quality of life and healthcare costs.
  • Effective prevention strategies for CPSP are needed.

Purpose of the Study:

  • To determine the prevalence of CPSP after thoracic surgery.
  • To characterize the features of CPSP, including neuropathic pain.
  • To identify risk factors associated with CPSP development.

Main Methods:

  • Prospective cohort study at a single tertiary care center.
  • 285 adult patients undergoing thoracic surgery were followed for 12 months.
  • Data collected included demographics, psychological status, and pain assessments at 3, 6, and 12 months post-surgery.

Main Results:

  • CPSP prevalence was 32.4% at 3 months, 25.4% at 6 months, and 18.2% at 12 months.
  • Nearly half of patients with CPSP at 3 months reported neuropathic pain features (71% by 1 year).
  • Independent predictors for CPSP at 3 months included higher anxiety/depression scores and acute postoperative pain.

Conclusions:

  • Approximately one in three patients experience CPSP three months post-thoracic surgery.
  • A significant proportion of CPSP cases exhibit neuropathic characteristics.
  • Preoperative anxiety, depression, and acute postoperative pain are potential risk factors for CPSP.