Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan.
Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Pain Res Manag. 2020 Nov 4;2020:8814290. doi: 10.1155/2020/8814290. eCollection 2020.
Osteoporotic fractures are common among older people, and hip fractures (HF) can be devastating. Surgery is indicated for most cases of HF, and chronic persistent postoperative pain is likely to occur. This study investigated the multifaceted factors related to persistent pain occurring during the acute phase and subacute phase of recovery after HF surgery. We conducted a prospective 8-week study of older HF patients after surgery. We evaluated pain intensity, depression symptoms, the fear of falling, pain catastrophizing, cognition and attention, the ability to perform activities of daily living, and the physical performance at 2 weeks (acute phase) and at 4 weeks (subacute phase) after surgery. Patients were divided into the light group (Verbal Rating Scale (VRS) score ≤1) and severe group (VRS score ≥2) according to pain intensity at 8 weeks (recovery phase) after surgery. Factors affecting persistent postoperative pain during recovery were examined using logistic regression analysis. Seventy-two patients were analyzed: 50 in the light group and 22 in the severe group. In the severe group, pain with movement and Pain Catastrophizing Scale scores were higher than those of the light group at 2 weeks and at 4 weeks after surgery. The regression analysis showed that pain with movement at 2 weeks and at 4 weeks after surgery and pain catastrophizing at 4 weeks after surgery were related to persistent postoperative pain. HF patients may have persistent pain if they continue to experience pain and catastrophize their pain during the acute phase and subacute phase after surgery.
骨质疏松性骨折在老年人中很常见，髋部骨折（HF）可能是毁灭性的。大多数 HF 病例都需要手术，并且慢性持续的术后疼痛很可能发生。本研究调查了与 HF 手术后急性和亚急性恢复期间持续疼痛相关的多方面因素。我们对手术后的老年 HF 患者进行了一项前瞻性 8 周研究。我们评估了疼痛强度、抑郁症状、跌倒恐惧、疼痛灾难化、认知和注意力、日常生活活动能力以及手术后 2 周（急性阶段）和 4 周（亚急性阶段）的身体表现。根据手术后 8 周（恢复阶段）的疼痛强度，患者分为轻度组（VRS 评分≤1）和重度组（VRS 评分≥2）。使用逻辑回归分析检查了影响恢复期间持续术后疼痛的因素。对 72 名患者进行了分析：轻度组 50 名，重度组 22 名。在重度组中，与轻度组相比，手术后 2 周和 4 周时的运动疼痛和疼痛灾难化量表评分更高。回归分析表明，手术后 2 周和 4 周时的运动疼痛和手术后 4 周时的疼痛灾难化与持续术后疼痛相关。如果 HF 患者在手术后的急性和亚急性阶段持续感到疼痛并对疼痛产生灾难化，他们可能会持续疼痛。
