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Cited by 206Anesthesia and Pain ManagementCardiac and Coronary Surgery TechniquesPediatric Pain Management Techniques

Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study

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Choinière, Manon, Watt-Watson, Judy, Victor, J. Charles, Baskett, Roger J.F., Bussières, Jean S., Carrier, Michel, Cogan, Jennifer, Costello, Judy +4 more·2014·Canadian Medical Association Journal
DOI 10.1503/cmaj.131012PMC PMC3986330
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Abstract

BACKGROUND: Persistent postoperative pain continues to be an underrecognized complication. We examined the prevalence of and risk factors for this type of pain after cardiac surgery. METHODS: We enrolled patients scheduled for coronary artery bypass grafting or valve replacement, or both, from Feb. 8, 2005, to Sept. 1, 2009. Validated measures were used to assess (a) preoperative anxiety and depression, tendency to catastrophize in the face of pain, health-related quality of life and presence of persistent pain; (b) pain intensity and interference in the first postoperative week; and (c) presence and intensity of persistent postoperative pain at 3, 6, 12 and 24 months after surgery. The primary outcome was the presence of persistent postoperative pain during 24 months of follow-up. RESULTS: A total of 1247 patients completed the preoperative assessment. Follow-up retention rates at 3 and 24 months were 84% and 78%, respectively. The prevalence of persistent postoperative pain decreased significantly over time, from 40.1% at 3 months to 22.1% at 6 months, 16.5% at 12 months and 9.5% at 24 months; the pain was rated as moderate to severe in 3.6% at 24 months. Acute postoperative pain predicted both the presence and severity of persistent postoperative pain. The more intense the pain during the first week after surgery and the more it interfered with functioning, the more likely the patients were to report persistent postoperative pain. Pre-existing persistent pain and increased preoperative anxiety also predicted the presence of persistent postoperative pain. INTERPRETATION: Persistent postoperative pain of nonanginal origin after cardiac surgery affected a substantial proportion of the study population. Future research is needed to determine whether interventions to modify certain risk factors, such as preoperative anxiety and the severity of pain before and immediately after surgery, may help to minimize or prevent persistent postoperative pain.

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  • Pain intensity in the weeks after surgery reliably predicts chronic postsurgical pain.

    “The data clearly show that the presence32 and intensity of preoperative chronic pain,6,33–35 the intensity of acute postoperative pain,6,23,32,33,36 the time spent in severe pain after surgery,6 pain intensity in the weeks after surgery,35,37,38 and pain in other body parts32,34,39 reliably predict CPSP across a range of surgical procedures.”

    From Chronic postsurgical pain: From risk factor identification to multidisciplinary management at the Toronto General Hospital Transitional Pain Service (2019) · cites this paper as [35]

    The Results and Interpretation (page unavailable) identify acute pain intensity on postoperative day 3 as a predictor of persistent pain after cardiac surgery. They do not establish that pain intensity measured over the weeks after surgery reliably predicts chronic pain across a range of surgical procedures; the other first-week predictor was pain interference on day 7. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The presence and intensity of preoperative chronic pain reliably predict chronic postsurgical pain across a range of surgical procedures.

    “The data clearly show that the presence32 and intensity of preoperative chronic pain,6,33–35 the intensity of acute postoperative pain,6,23,32,33,36 the time spent in severe pain after surgery,6 pain intensity in the weeks after surgery,35,37,38 and pain in other body parts32,34,39 reliably predict CPSP across a range of surgical procedures.”

    From Chronic postsurgical pain: From risk factor identification to multidisciplinary management at the Toronto General Hospital Transitional Pain Service (2019) · cites this paper as [35]

  • Perioperative anxiety predicts the development of chronic postsurgical pain.

    “Negative cognitive–affective states including perioperative depression,42,43 anxiety,25,32,35,43,44 pain catastrophizing,18,44 and posttraumatic stress symptoms45 also predict the development of CPSP.”

    From Chronic postsurgical pain: From risk factor identification to multidisciplinary management at the Toronto General Hospital Transitional Pain Service (2019) · cites this paper as [35]

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1 of the 44 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. [12]12. Kalso E, Mennander S, Tasmuth T, et al. Chronic post-ster- notomy pain. Acta Anaesthesiol Scand 2001;45:935-9.
  2. [24]24. VanDenKerkhof EG, Peters ML, Bruce J. Chronic pain after surgery: Time for standardization? A framework to establish core risk factor and outcome domains for epidemiological stud- ies. Clin J Pain 2013;29:2-8.
  3. [38]38. Schug SA, Pogatzki-Zahn EM. Chronic pain after surgery or injury. Pain Clin Updates 2011;19:1-5.

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Authors
Choinière, M., Watt-Watson, J., Victor, J. C., Baskett, R. J. F., Bussières, J. S., Carrier, M., Cogan, J., Costello, J., Feindel, C., Guertin, M.-C., Racine, M., & Taillefer, M.-C.
Affiliations
Dalhousie University (CA)
ORCID
Venue
Canadian Medical Association Journal
Publisher
CMA Joule Inc.
Published
2014-02-24
Volume
186
Issue
7
Pages
E213-E223
ISSN
  • 0820-3946 (ISSN-L)
  • 1488-2329
DOI
10.1503/cmaj.131012
PMC
PMC3986330
OpenAlex
W2104465167
Semantic Scholar
448591f3aab35bc040bc84f243defd9fb4d12855
Cited by
206
References
44
Citations by year
2026: 7 · 2025: 17 · 2024: 10 · 2023: 18 · 2022: 24 · 2021: 18 · 2020: 17 · 2019: 21 · 2018: 14 · 2017: 16 · 2016: 16 · 2015: 16 · 2014: 12
FWCI
19.80
Type
journal article
Language
en
Open access
Locations
  • Canadian Medical Association Journal (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Canadian Institutes of Health Research (69065_1)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
chronic postoperative pain, cardiac surgery complications, coronary artery bypass grafting, heart valve replacement, risk factors, preoperative anxiety, preoperative depression, pain catastrophizing, health-related quality of life, acute postoperative pain, prevalence
MeSH terms
Adult, Aged, Aged, 80 and over, Coronary Artery Bypass, Canada, Female, Follow-Up Studies, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Pain Measurement, Postoperative Pain, Prospective Studies, Quality of Life, Risk Factors, Severity of Illness Index, Time Factors, Prevalence, Risk Assessment, Young Adult

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