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Updated: May 16, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Presurgical Prognostic Factors for Chronic Postsurgical Pain Across Developmental Stages in Children, Adolescents,
Guillermo Ceniza-Bordallo1,2, Christine B Sieberg1,2,3, Ibai Lopez-de-Uralde-Villanueva4
1Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, USA.
Insights
Baseline pain intensity is the strongest predictor of chronic postsurgical pain (CPSP) in young people. Other factors like age and psychological traits showed limited predictive value for CPSP.
Area of Science:
- Pain Medicine
- Pediatric Surgery
- Adolescent Health
Background:
- Chronic postsurgical pain (CPSP) impacts children and adolescents, with lasting effects into adulthood.
- Predictors of CPSP are inconsistent, lacking a developmental perspective.
- This review focuses on presurgical prognostic factors for CPSP across childhood, adolescence, and young adulthood.
Purpose of the Study:
- To identify presurgical prognostic factors for chronic postsurgical pain (CPSP).
- To examine CPSP at 3, 6, 12, and 24 months post-surgery.
- To analyze prognostic factors across a developmental spectrum from childhood to young adulthood.
Main Methods:
- Systematic search of five databases (inception-September 2025) following PRISMA guidelines.
- Included studies: participants aged 8-22 years undergoing major surgery with reported presurgical variables for CPSP.
- Data extraction, risk of bias assessment, and meta-analyses (SMD or OR) by two independent reviewers.
Main Results:
- Thirty articles analyzed; 44 presurgical factors identified, only 8 meta-analyzed due to inconsistent reporting.
- Baseline pain intensity consistently predicted CPSP at 3 and 6 months.
- Older age showed a minor association at 3 months; sex and psychological factors (catastrophizing, anxiety) were not significant predictors.
Conclusions:
- Baseline presurgical pain intensity is the most reliable predictor of CPSP in young individuals.
- Psychological and sociodemographic factors demonstrated limited prognostic value.
- Inconsistent reporting and small sample sizes limit quantitative conclusions on CPSP predictors.
Background:
Chronic postsurgical pain (CPSP) is a significant postoperative complication in children and adolescents, with long-term consequences that may extend into young adulthood. Although numerous presurgical factors have been proposed as potential predictors of CPSP, findings remain inconsistent, and no prior review has examined prognostic factors across a developmental window spanning childhood to young adulthood. The aim of this study was to identify presurgical prognostic factors for CPSP at 3, 6, 12, and 24 months after surgery in children, adolescents, and young adults.
Methods:
A systematic search of five electronic databases was conducted from inception to September 2025, following PRISMA guidelines. Eligible studies included participants aged 8-22 years undergoing major surgery and reporting presurgical variables associated with CPSP. Two reviewers independently screened studies, extracted data, and assessed risk of bias. When possible, meta-analyses were performed using standardized mean differences or odds ratios.
Results:
Thirty articles were included. Although 44 presurgical factors were identified, only eight could be meta-analyzed due to inconsistent reporting, limiting the strength of quantitative conclusions. Baseline pain intensity was the most consistent predictor of CPSP, showing significant associations at 3 months and 6 months. Older age showed a small association with CPSP at 3 months but not thereafter. Sex, child pain catastrophizing, pain anxiety, anxiety sensitivity, parent pain catastrophizing, and parent pain anxiety were not significantly associated with CPSP. The evidence base was limited by heterogeneity, small samples, and underreporting of effect sizes.
Conclusion:
Across childhood, adolescence, and young adulthood, baseline presurgical pain intensity is the most robust predictor of CPSP. Psychological and sociodemographic factors showed limited prognostic value. However, quantitative conclusions are limited by inconsistent reporting across studies.
