+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Psychological factors predict an unfavorable pain trajectory after hysterectomy: a prospective cohort study on chronic postsurgical pain

Psychological factors predict an unfavorable pain trajectory after hysterectomy: a prospective cohort study on chronic postsurgical pain

Pain 159(5): 956-967

Chronic postsurgical pain (CPSP) is a well-recognized potential complication with negative personal, social, and health care consequences. However, limited data exist on CPSP and on the course of pain over time after hysterectomy. Using data from a prospective cohort study on a consecutive sample assessed at 4 time points, presurgery (T1), 48 hours (T2), 4 months (T3), and 5 years postsurgery (T4), we sought to examine women's PSP trajectories using assessments of pain at T3 and T4. In addition, this study aimed to investigate presurgical and postsurgical risk factors associated with an unfavourable pain trajectory (PT). Based on pain data collected at T3 and T4, 3 distinct trajectories of PSP emerged: no CPSP (PT1; n = 88), prolonged PSP (PT2; n = 53), and CPSP (PT3; n = 29). Moreover, reported CPSP prevalence at 5 years was 17.1%. Multinomial logistic regression models controlling for age, presurgical pain, and type of hysterectomy tested for baseline and acute postsurgical predictive variables. Membership in PT2 and PT3 was predicted by presurgical anxiety (odds ratio [OR] = 1.131, P = 0.015; OR = 1.175, P = 0.009, respectively), emotional representation of the surgical disease (OR = 1.155, P = 0.034; OR = 1.213, P = 0.020, respectively), and pain catastrophizing (OR = 1.079, P = 0.043; OR = 1.143, P = 0.001, respectively). Furthermore, acute PSP intensity and frequency determined membership of women in PT3 (OR = 1.211, P = 0.033; OR = 3.000, P = 0.029, respectively), and postsurgical anxiety (OR = 1.182, P = 0.026) also played a key predictive role. This study identified factors that can be easily screened before and after surgery and are amenable to change through carefully designed timely and tailored interventions for women at risk of an unfavorable PSP trajectory posthysterectomy.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 065446991

Download citation: RISBibTeXText

PMID: 29419656

DOI: 10.1097/j.pain.0000000000001170

Related references

Surgical patients with chronic pain or chronic postsurgical pain: a prospective analysis of psychological and social factors. Schmerz 27(6): 597-604, 2013

Genetic and Clinical Factors Associated with Chronic Postsurgical Pain after Hernia Repair, Hysterectomy, and Thoracotomy: A Two-year Multicenter Cohort Study. Anesthesiology 122(5): 1123-1141, 2015

Acute postoperative pain is an independent predictor of chronic postsurgical pain following total knee arthroplasty at 6 months: a prospective cohort study. Regional Anesthesia and Pain Medicine 2019:, 2019

Prevalence and Predictive Factors of Chronic Postsurgical Pain and Global Surgical Recovery 1 Year After Outpatient Knee Arthroscopy: A Prospective Cohort Study. Medicine 94(45): E2017, 2015

Incidence and association factors for the development of chronic post-hysterectomy pain at 4- and 6-month follow-up: a prospective cohort study. Journal of Pain Research 11: 629-636, 2018

Risk factors for persistent postsurgical pain in women undergoing hysterectomy due to benign causes: a prospective predictive study. Journal of Pain 13(11): 1045-1057, 2012

Influence of psychological factors on the prognosis of chronic shoulder pain: protocol for a prospective cohort study. Bmj Open 7(3): E012822, 2017

A Prospective Cohort Study Evaluating the Ability of Anticipated Pain, Perceived Analgesic Needs, and Psychological Traits to Predict Pain and Analgesic Usage following Cesarean Delivery. Anesthesiology Research and Practice 2016: 7948412, 2016

Identification of pain-related psychological risk factors for the development and maintenance of pediatric chronic postsurgical pain. Journal of Pain Research 6: 167-180, 2013

Chronic postsurgical pain in patients 5 years after cardiac surgery: A prospective cohort study. European Journal of Pain 21(3): 425-433, 2017

Psychological risk factors for chronic post-surgical pain after inguinal hernia repair surgery: a prospective cohort study. European Journal of Pain 16(4): 600-610, 2012

Chronic postsurgical pain in children: prevalence and risk factors. A prospective observational study. British Journal of Anaesthesia 117(4): 489-496, 2016

Impact of perioperative pain intensity, pain qualities, and opioid use on chronic pain after surgery: a prospective cohort study. Regional Anesthesia and Pain Medicine 37(1): 19-27, 2012

Postsurgical pain syndromes Chronic pain after hysterectomy and cesarean section. Techniques in Regional Anesthesia and Pain Management 15(3): 133-139, 2011

Genetic and Clinical Factors Associated With Chronic Postsurgical Pain After Hernia Repair, Hysterectomy, and Thoracotomy. Survey of Anesthesiology 60(2): 86-87, 2016