Model Can Predict Chronic Postsurgical Pain

Four easily obtainable factors can reliably predict chronic postsurgical pain, according to a study published online June 19 in the British Journal of Anaesthesia.

Marjelle E.C. van Driel, from the University Medical Centre Utrecht in the Netherlands, and colleagues developed a prognostic model to predict chronic postsurgical pain, including pain characteristics indicating altered pain processing within two weeks after surgery. The development cohort included 344 adult patients undergoing orthopedic, vascular, trauma, or general surgery between 2018 and 2019 and 150 adults in the validation cohort.

The researchers found that 28.8 percent of patients in the development cohort and 21.3 percent in the validation cohort reported chronic postsurgical pain. The best performing model (area under the curve, 0.82) included preoperative treatment with opioids (odds ratio, 4.04), bone surgery (odds ratio, 2.01), numerical rating scale pain score on postoperative day 14 (odds ratio, 1.57), and the presence of painful cold within the painful area two weeks after surgery (odds ratio, 4.85).

“Identification of the presence of painful cold within two weeks after surgery as a strong predictor supports altered pain processing as an important contributor to chronic postsurgical pain development,” the authors write. “The relevance of this model to predict chronic postsurgical pain at one year and its impact on therapeutic management must now be determined.”