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Cited by 356Anesthesia and Pain ManagementEnhanced Recovery After SurgeryMusculoskeletal pain and rehabilitation

Somatic and Psychologic Predictors of Long-term Unfavorable Outcome After Surgical Intervention

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Peters, Madelon L., Sommer, Micha, de Rijke, Janneke M., Kessels, Fons, Heineman, Erik, Patijn, Jacob, Marcus, Marco A. E., Vlaeyen, Johan W. S. +1 more·2007·Annals of Surgery
DOI 10.1097/01.sla.0000245495.79781.65PMC PMC1877005
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Abstract

OBJECTIVE: To identify somatic and psychologic predictors of pain, functional limitations, global perceived recovery, and quality of life 6 months after surgical intervention. SUMMARY BACKGROUND DATA: Recent studies have indicated that chronic pain after surgical intervention is more common than previously assumed. Several demographic and somatic predictors of long-term unfavorable outcome have been identified, but little is known about the contribution of psychologic risk factors. METHODS: A prospective cohort study, including 625 patients undergoing elective surgery at the University Hospital Maastricht, The Netherlands, was conducted between February and August 2003. Psychologic questionnaires were completed preoperatively and acute postoperative pain was recorded until 4 days after the operation. Six months later, all patients received follow-up questionnaires to assess pain, functional limitations, global perceived recovery, and quality of life. Multivariable logistic regression analyses were used to estimate relative risk of poor outcome in terms of pain, functional limitations, and global recovery. Multivariable linear regression analysis was used to assess associations with quality of life at 6 months. RESULTS: The most important somatic predictors of unfavorable outcome were duration of the operation and high levels of acute postoperative pain. Patients reporting high levels of pain 4 days after the operation and patients undergoing an operation of longer than 3 hours were at risk for increased pain, increased functional limitations, poor global recovery, and reported lower levels of quality of life 6 months after the operation. Psychologic variables that influenced long-term outcome were preoperative fear of surgery and optimism. Fear of the long-term consequences of the operation was associated with more pain, poor global recovery, and worse quality of life 6 months later, whereas optimism was associated with better recovery and higher quality of life. CONCLUSIONS: This study was the first to identify the joint contribution of somatic and psychologic factors to chronic pain, functional limitations, and quality of life 6 months after surgical interventions. It replicates previous findings that intense acute postoperative pain is a risk factor for long-term adverse outcome and also identified additional risk factors, namely, long duration of the operation, ASA status, and preoperative fear of surgery.

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Authors
Peters, M. L., Sommer, M., de Rijke, J. M., Kessels, F., Heineman, E., Patijn, J., Marcus, M. A. E., Vlaeyen, J. W. S., & van Kleef, M.
Affiliations
Maastricht University Medical Centre (NL)
Corresponding author
  • Peters, Madelon L.
  • Vlaeyen, Johan W. S.
ORCID
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2007-03
Volume
245
Issue
3
Pages
487-494
ISSN
0003-4932 (ISSN-L)
DOI
10.1097/01.sla.0000245495.79781.65
PMC
PMC1877005
OpenAlex
W2042343125
Cited by
356
References
8
Citations by year
2026: 15 · 2025: 15 · 2024: 12 · 2023: 16 · 2022: 18 · 2021: 24 · 2020: 22 · 2019: 15 · 2018: 19 · 2017: 18 · 2016: 26 · 2015: 16 · 2014: 27 · 2013: 33 · 2012: 21
FWCI
13.98
Type
journal article
Language
en
Open access
Locations
  • Annals of Surgery (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
chronic postoperative pain, long-term surgical outcomes, acute postoperative pain, operation duration, optimism, quality of life, functional limitations, ASA physical status, elective surgery
MeSH terms
Fear, Humans, Middle Aged, Pain, Postoperative, Postoperative Pain, Quality of Life, Surgical Procedures, Operative, Time Factors, Logistic Models, Treatment Outcome, Recovery of Function, Principal Component Analysis

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