A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on qualify of life

Zhiyou Peng; Huiling Li; Chong Zhang; Xiang Qian; Zhiying Feng; Shengmei Zhu

doi:10.1371/journal.pone.0090014

A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on qualify of life

PLoS One. 2014 Feb 28;9(2):e90014. doi: 10.1371/journal.pone.0090014. eCollection 2014.

Authors

Zhiyou Peng¹, Huiling Li¹, Chong Zhang², Xiang Qian³, Zhiying Feng¹, Shengmei Zhu¹

Affiliations

¹ Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
² Department of Thoracic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
³ Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, United States of America.

Abstract

Background: Thoracic surgeries including thoracotomy and VATS are some of the highest risk procedures that often lead to CPSP, with or without a neuropathic component. This retrospective study aims to determine retrospectively the prevalence of CPSP following thoracic surgery, its predicting risk factors, the incidence of neuropathic component, and its impact on quality of life.

Methods: Patients who underwent thoracic surgeries including thoracotomy and VATS between 01/2010 and 12/2011 at the First Affiliated Hospital, School of Medicine, Zhejiang University were first contacted and screened for CPSP following thoracic surgery via phone interview. Patients who developed CPSP were then mailed with a battery of questionnaires, including a questionnaire referenced to Maguire's research, a validated Chinese version of the ID pain questionnaire, and a SF-36 Health Survey. Logistic regression analyses were subsequently performed to identify risk factors for CPSP following thoracic surgery and its neuropathic component.

Results: The point prevalence of CPSP following thoracic surgery was 24.9% (320/1284 patients), and the point prevalence of neuropathic component of CPSP was 32.5% (86/265 patients). CPSP following thoracic surgery did not improve significantly with time. Multiple predictive factors were identified for CPSP following thoracic surgery, including age<60 years old, female gender, prolonged duration of post-operative chest tube drainage (≥ 4 days), options of post-operative pain management, and pre-existing hypertension. Furthermore, patients who experienced CPSP following thoracic surgery were found to have significantly decreased physical function and worse quality of life, especially those with neuropathic component.

Conclusions: Our study demonstrated that nearly 1 out of 4 patients underwent thoracic surgery might develop CPSP, and one third of them accompanied with a neuropathic component. Early prevention as well as aggressive treatment is important for patients with CPSP following thoracic surgery to achieve a high quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors
Aged
Chronic Pain / etiology
Chronic Pain / physiopathology
Chronic Pain / psychology*
Female
Humans
Male
Middle Aged
Pain Measurement
Pain, Postoperative / etiology
Pain, Postoperative / physiopathology
Pain, Postoperative / psychology*
Quality of Life / psychology*
Retrospective Studies
Risk Factors
Sex Factors
Surveys and Questionnaires
Thoracic Surgical Procedures / adverse effects*

Grants and funding

This study was supported by the grants from the Zhejiang Provincial Natural Science Foundation of China (Grant No. Y12H030053). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.