预测小儿开胸术后疼痛的高级统计方法：一项使用零膨胀模型和泊松模型的横断面研究
Advanced statistical approaches for predicting pain after pediatric thoracotomy: a cross-sectional study using zero-inflated and Poisson models.
作者信息
Vittori Alessandro, Cascella Marco, Di Gennaro Piergiacomo, Marchetti Giuliano, Francia Elisa, Mascilini Ilaria, Tarquini Riccardo, Innamorato Massimo Antonio, Petrucci Emiliano, Marinangeli Franco, Coluccia Sergio, Picardo Sergio Giuseppe
机构信息
Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, 00165, Rome, Italy.
Department of Medicine, Surgery, and Dentistry, Unit of Anesthesiology, Intensive Care Medicine, and Pain Medicine, University of Salerno, Baronissi, 84081, Salerno, Italy.
出版信息
J Anesth Analg Crit Care. 2024 Aug 5;4(1):53. doi: 10.1186/s44158-024-00188-w.
BACKGROUND
Thoracotomy is one of the surgical procedures most burdened by chronic post-operative pain. There is poor evidence regarding the possibility that even in pediatric patients, thoracotomy can be followed by post-operative pain. The primary objective of this analysis is to identify associations with home pain therapy, pain intensity, and possible protective factors acting on chronic pain in this population.
METHODS
A retrospective cross-sectional study was conducted at Ospedale Pediatrico Bambino Gesù IRCCS. The study included pediatric patients undergoing thoracotomy. For statistical analyses, a logistic model and a zero-inflated strategy were implemented to explore associations and predict factors related to home-based analgesic therapy and pain intensity.
RESULTS
Gender and age were identified as significant factors in the assignment of home therapy, with males having over seven times the risk compared to females (OR = 7.06, 95% CI = [2.11, 29.7]). At the last measurement, pain intensity was positively associated with age and the number of pain events during the week.
CONCLUSIONS
The study highlights significant factors influencing post-thoracotomy pain management in pediatric patients. These findings underscore the importance of tailored pain management strategies that consider gender and age to improve post-operative care and outcomes in pediatric thoracotomy patients.
背景
开胸手术是术后慢性疼痛负担最重的外科手术之一。关于即使在儿科患者中开胸手术后也会出现疼痛这一可能性，证据不足。本分析的主要目的是确定该人群中与家庭疼痛治疗、疼痛强度以及对慢性疼痛起作用的可能保护因素之间的关联。
方法
在罗马儿童医院（Ospedale Pediatrico Bambino Gesù IRCCS）进行了一项回顾性横断面研究。该研究纳入了接受开胸手术的儿科患者。为进行统计分析，采用了逻辑模型和零膨胀策略来探索与家庭镇痛治疗和疼痛强度相关的关联及预测因素。
结果
性别和年龄被确定为家庭治疗分配中的重要因素，男性接受家庭治疗的风险是女性的七倍多（比值比=7.06，95%置信区间=[2.11, 29.7]）。在最后一次测量时，疼痛强度与年龄以及一周内疼痛事件的数量呈正相关。
结论
该研究突出了影响儿科患者开胸手术后疼痛管理的重要因素。这些发现强调了制定考虑性别和年龄的个性化疼痛管理策略对于改善儿科开胸手术患者术后护理及预后的重要性。
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