Variability in Self-Reported Preoperative Pain Between Clinic Visits and Day of Surgery

Area of Science:

• Orthopedics
• Pain Management
• Clinical Research

Background:

• Preoperative pain assessment is crucial for benchmarking and clinical parameter comparison.
• Variability in pain scores can affect study outcomes and patient management.
• Standardized definition and minimal variability of baseline pain are necessary.

Purpose of the Study:

• To determine variability in patient-reported pain scores on the day of surgery (DOS) compared to preoperative clinic visits.
• To identify potential sources of interstudy variability in pain reporting.
• To emphasize the importance of defining the timing and setting of preoperative pain assessments.

Main Methods:

• Retrospective analysis of 1,567 patients undergoing total knee arthroplasty (TKA), total hip arthroplasty (THA), and spinal fusion (SF).
• Comparison of self-reported 0-10 numeric rating scale (NRS) pain scores between clinic visits and DOS.
• Secondary analyses stratified by procedure, gender, and time of clinic visit; qualitative literature review on pain assessment timing.

Main Results:

• Patients reported significantly greater pain during clinic visits compared to DOS (median difference of 3, p < 0.0001).
• This discrepancy was consistent across TKA, THA, and SF procedures and unaffected by gender.
• Pain score differences persisted for clinic visits within 90 days of surgery; literature review found timing is rarely reported.

Conclusions:

• Patient-reported pain differs significantly between clinic visits and the day of surgery.
• This variability is a potential source of interstudy discrepancies in pain research.
• Standardizing the timing and setting of preoperative pain assessments is critical for accurate clinical research.