Incidence and Influencing Factors of Chronic Postthoracotomy Pain in Lung Tumor Patients

OBJECTIVES: To estimate the incidence of chronic postthoracotomy pain (CPTP) in lung tumor patients and to explore the influencing factors of the intensity of CPTP. METHODS: Lung tumor patients who underwent video-assisted thoracoscopic surgery (VATS) or thoracotomy were consecutively recruited from October 2016 to December 2017 at Yunnan Cancer Hospital. All the eligible patients were interviewed via telephone at the end of the third month after surgeries to identify the presence of CPTP. The potential influencing factors of CPTP, including pre-, intra-, and postoperative variables, were collected from medical records. A cumulative logit regression model was used to identify the independent influencing factors of the intensity of CPTP. RESULTS: Three hundred and forty-three patients completed a telephone interview. The estimated overall incidence of CPTP was 67.6% (95% of confidence interval, 95% CI: 62.4%, 72.6%) in lung tumor patients; 70.8% (95% CI: 63.8%, 77.1%) in benign patients and 63.5% (95% CI: 55.2%, 71.3%) in malignant patients; and 78.1% (95% CI: 66.0%, 87.5%) in open chest and 65.2% (95% CI: 59.3%, 70.8%) in VATS. Cumulative logit regression models (intensity order, NRS, 0 ⟶ 1–3 ⟶ 4-) revealed independent influencing factors of CPTP to be patients with diabetes (OR = 0.32; 95% CI: 0.14, 0.76), usage of VATS (OR = 0.47; 95% CI: 027, 0.82), and the amount of intraoperative blood loss (OR = 1.09; 95% CI: 1.00, 1.19). CONCLUSIONS: A high incidence of CPTP is detected in lung tumor patients following the thoracic operation. Patients with diabetes and using VATS are the independent protective factors of the intensity of CPTP, and the increasing amount of intraoperative blood loss is an independent risk factor of the intensity of CPTP.