1 Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
2 Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Cephalalgia. 2019 Feb;39(2):286-295. doi: 10.1177/0333102418786457. Epub 2018 Jul 8.
Migraine has been identified as a risk factor of 30-day hospital readmission after surgery. We aimed to further characterize this association examining pain as a potentially migraine-associated, preventable reason for readmission.
Compared to patients with no migraine, surgical patients with migraine are at increased risk of 30-day hospital readmission with an admitting diagnosis specifying pain.
This hospital registry study examined 150,710 patients aged 18 years and above, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and two affiliated community hospitals in Massachusetts, USA.
Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio 1.42 [95% confidence interval 1.15-1.75]). The association was stronger for migraine with aura (compared to migraine without aura: Adjusted odds ratio 1.69 [95% confidence interval 1.06-2.70]; compared to no migraine: Adjusted odds ratio 2.20 [95% confidence interval 1.44-3.37]). The predicted adjusted risk of pain-related 30-day readmissions was 9.1 [95% confidence interval 5.3-13.0] in 1000 surgical patients with migraine with aura and 5.4 [95% confidence interval 4.2-6.6] in 1000 patients with migraine without aura, compared to 4.2 [95% confidence interval 3.8-4.5] in 1000 patients with no migraine. Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted odds ratio 1.55 [95% confidence interval 1.20-2.00]).
Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain.
偏头痛已被确定为手术后 30 天内再次住院的一个危险因素。我们旨在通过检查疼痛作为潜在的偏头痛相关、可预防的再次入院原因，进一步描述这种关联。
与没有偏头痛的患者相比，患有偏头痛的手术患者因疼痛而再次入院的风险增加，入院诊断明确为疼痛。
这项医院登记研究调查了 150710 名年龄在 18 岁及以上的患者，他们在 2007 年至 2015 年间在美国马萨诸塞州的一家三级护理中心和两家附属社区医院接受全身麻醉和机械通气下的手术。
偏头痛与手术后 30 天内与疼痛相关的再入院风险增加相关（调整后的优势比 1.42 [95%置信区间 1.15-1.75]）。偏头痛伴先兆（与无先兆偏头痛相比：调整后的优势比 1.69 [95%置信区间 1.06-2.70]；与无偏头痛相比：调整后的优势比 2.20 [95%置信区间 1.44-3.37]）的关联更强。偏头痛伴先兆的 1000 例手术患者中，预测的 30 天内与疼痛相关的再入院调整风险为 9.1 [95%置信区间 5.3-13.0]，而偏头痛不伴先兆的 1000 例患者中为 5.4 [95%置信区间 4.2-6.6]，而 1000 例无偏头痛的患者中为 4.2 [95%置信区间 3.8-4.5]。此外，偏头痛与术前定义的偏头痛相关疼痛（头痛或腹痛）导致的术后 30 天内再次住院的风险增加相关（调整后的优势比 1.55 [95%置信区间 1.20-2.00]）。
接受手术的偏头痛患者因疼痛再次入院的风险增加。
