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Effect of acute postsurgical pain trajectories on 30-day and 1-year pain

Untreated pain after surgery leads to poor patient satisfaction, longer hospital length of stay, lower health-related quality of life, and non-compliance with rehabilitation regimens. The aim of this study is to characterize the structure of acute pain trajectories during the postsurgical hospitaliz...

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Autores principales: Awadalla, Saria S., Winslow, Victoria, Avidan, Michael S., Haroutounian, Simon, Kannampallil, Thomas G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187125/
https://www.ncbi.nlm.nih.gov/pubmed/35687544
http://dx.doi.org/10.1371/journal.pone.0269455
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author Awadalla, Saria S.
Winslow, Victoria
Avidan, Michael S.
Haroutounian, Simon
Kannampallil, Thomas G.
author_facet Awadalla, Saria S.
Winslow, Victoria
Avidan, Michael S.
Haroutounian, Simon
Kannampallil, Thomas G.
author_sort Awadalla, Saria S.
collection PubMed
description Untreated pain after surgery leads to poor patient satisfaction, longer hospital length of stay, lower health-related quality of life, and non-compliance with rehabilitation regimens. The aim of this study is to characterize the structure of acute pain trajectories during the postsurgical hospitalization period and quantify their association with pain at 30-days and 1-year after surgery. This cohort study included 2106 adult (≥18 years) surgical patients who consented to participate in the SATISFY-SOS registry (February 1, 2015 to September 30, 2017). Patients were excluded if they did not undergo invasive surgeries, were classified as outpatients, failed to complete follow up assessments at 30-days and 1-year following surgery, had greater than 4-days of inpatient stay, and/or recorded fewer than four pain scores during their acute hospitalization period. The primary exposure was the acute postsurgical pain trajectories identified by a machine learning-based latent class approach using patient-reported pain scores. Clinically meaningful pain (≥3 on a 0–10 scale) at 30-days and 1-year after surgery were the primary and secondary outcomes, respectively. Of the study participants (N = 2106), 59% were female, 91% were non-Hispanic White, and the mean (SD) age was 62 (13) years; 41% of patients underwent orthopedic surgery and 88% received general anesthesia. Four acute pain trajectory clusters were identified. Pain trajectories were significantly associated with clinically meaningful pain at 30-days (p = 0.007), but not at 1-year (p = 0.79) after surgery using covariate-adjusted logistic regression models. Compared to Cluster 1, the other clusters had lower statistically significant odds of having pain at 30-days after surgery (Cluster 2: [OR = 0.67, 95%CI (0.51–0.89)]; Cluster 3:[OR = 0.74, 95%CI (0.56–0.99)]; Cluster 4:[OR = 0.46, 95%CI (0.26–0.82)], all p<0.05). Patients in Cluster 1 had the highest cumulative likelihood of pain and pain intensity during the latter half of their acute hospitalization period (48–96 hours), potentially contributing to the higher odds of pain during the 30-day postsurgical period. Early identification and management of high-risk pain trajectories can help in ascertaining appropriate pain management interventions. Such interventions can mitigate the occurrence of long-term disabilities associated with pain.
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spelling pubmed-91871252022-06-11 Effect of acute postsurgical pain trajectories on 30-day and 1-year pain Awadalla, Saria S. Winslow, Victoria Avidan, Michael S. Haroutounian, Simon Kannampallil, Thomas G. PLoS One Research Article Untreated pain after surgery leads to poor patient satisfaction, longer hospital length of stay, lower health-related quality of life, and non-compliance with rehabilitation regimens. The aim of this study is to characterize the structure of acute pain trajectories during the postsurgical hospitalization period and quantify their association with pain at 30-days and 1-year after surgery. This cohort study included 2106 adult (≥18 years) surgical patients who consented to participate in the SATISFY-SOS registry (February 1, 2015 to September 30, 2017). Patients were excluded if they did not undergo invasive surgeries, were classified as outpatients, failed to complete follow up assessments at 30-days and 1-year following surgery, had greater than 4-days of inpatient stay, and/or recorded fewer than four pain scores during their acute hospitalization period. The primary exposure was the acute postsurgical pain trajectories identified by a machine learning-based latent class approach using patient-reported pain scores. Clinically meaningful pain (≥3 on a 0–10 scale) at 30-days and 1-year after surgery were the primary and secondary outcomes, respectively. Of the study participants (N = 2106), 59% were female, 91% were non-Hispanic White, and the mean (SD) age was 62 (13) years; 41% of patients underwent orthopedic surgery and 88% received general anesthesia. Four acute pain trajectory clusters were identified. Pain trajectories were significantly associated with clinically meaningful pain at 30-days (p = 0.007), but not at 1-year (p = 0.79) after surgery using covariate-adjusted logistic regression models. Compared to Cluster 1, the other clusters had lower statistically significant odds of having pain at 30-days after surgery (Cluster 2: [OR = 0.67, 95%CI (0.51–0.89)]; Cluster 3:[OR = 0.74, 95%CI (0.56–0.99)]; Cluster 4:[OR = 0.46, 95%CI (0.26–0.82)], all p<0.05). Patients in Cluster 1 had the highest cumulative likelihood of pain and pain intensity during the latter half of their acute hospitalization period (48–96 hours), potentially contributing to the higher odds of pain during the 30-day postsurgical period. Early identification and management of high-risk pain trajectories can help in ascertaining appropriate pain management interventions. Such interventions can mitigate the occurrence of long-term disabilities associated with pain. Public Library of Science 2022-06-10 /pmc/articles/PMC9187125/ /pubmed/35687544 http://dx.doi.org/10.1371/journal.pone.0269455 Text en © 2022 Awadalla et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Awadalla, Saria S.
Winslow, Victoria
Avidan, Michael S.
Haroutounian, Simon
Kannampallil, Thomas G.
Effect of acute postsurgical pain trajectories on 30-day and 1-year pain
title Effect of acute postsurgical pain trajectories on 30-day and 1-year pain
title_full Effect of acute postsurgical pain trajectories on 30-day and 1-year pain
title_fullStr Effect of acute postsurgical pain trajectories on 30-day and 1-year pain
title_full_unstemmed Effect of acute postsurgical pain trajectories on 30-day and 1-year pain
title_short Effect of acute postsurgical pain trajectories on 30-day and 1-year pain
title_sort effect of acute postsurgical pain trajectories on 30-day and 1-year pain
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187125/
https://www.ncbi.nlm.nih.gov/pubmed/35687544
http://dx.doi.org/10.1371/journal.pone.0269455
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