Institute for Research in Operative Medicine (IFOM), Faculty of Medicine, University of Witten/Herdecke, Cologne, Germany.
Eur J Pain. 2012 Jul;16(6):901-10. doi: 10.1002/j.1532-2149.2011.00090.x. Epub 2011 Dec 23.
The incidence of chronic post-surgical pain (CPSP) after various common operations is 10% to 50%. Identification of patients at risk of developing chronic pain, and the management and prevention of CPSP remains inadequate. The aim of this study was to develop an easily applicable risk index for the detection of high-risk patients that takes into account the multifactorial aetiology of CPSP. A comprehensive item pool was derived from a systematic literature search. Items that turned out significant in bivariate analyses were then analysed multivariately, using logistic regression analyses. The items that yielded significant predictors in the multivariate analyses were compiled into an index. The cut-off score for a high risk of developing CPSP with an optimal trade-off between sensitivity and specificity was identified. The data of 150 patients who underwent different types of surgery were included in the analyses. Six months after surgery, 43.3% of the patients reported CPSP. Five predictors multivariately contributed to the prediction of CPSP: capacity overload, preoperative pain in the operating field, other chronic preoperative pain, post-surgical acute pain and co-morbid stress symptoms. These results suggest that several easily assessable preoperative and perioperative patient characteristics can predict a patient's risk of developing CPSP. The risk index may help caregivers to tailor individual pain management and to assist high-risk patients with pain coping.
手术后慢性疼痛（CPSP）的发生率在各种常见手术后为 10%至 50%。识别有发生慢性疼痛风险的患者，以及管理和预防 CPSP 仍然不足。本研究旨在开发一种易于应用的风险指数，以检测高风险患者，该指数考虑到 CPSP 的多因素病因。从系统文献检索中得出了一个全面的项目池。然后，对双变量分析中显著的项目进行多变量分析，使用逻辑回归分析。将多变量分析中产生显著预测因子的项目编制成指数。确定了一个具有最佳敏感性和特异性折衷的发展为 CPSP 的高风险的截断分数。对接受不同类型手术的 150 名患者的数据进行了分析。手术后 6 个月，43.3%的患者报告有 CPSP。五个预测因子对 CPSP 的预测有重要贡献：能力过载、手术部位的术前疼痛、其他慢性术前疼痛、术后急性疼痛和合并的应激症状。这些结果表明，一些易于评估的术前和围手术期患者特征可以预测患者发生 CPSP 的风险。风险指数可以帮助护理人员定制个体化的疼痛管理，并帮助高风险患者应对疼痛。
