Incidence and severity of chronic pain at 3 and 6 months after thoracotomy: meta-analysis

J Pain. 2014 Sep;15(9):887-97. doi: 10.1016/j.jpain.2014.06.005. Epub 2014 Jun 23.


This systematic review was performed to determine the incidence and the severity of chronic pain at 3 and 6 months after thoracotomy based on meta-analyses. We conducted MEDLINE, Web of Science, and Google Scholar searches of databases and references for English articles; 858 articles were reviewed. Meta-regression analysis based on the publication year was used to examine if the chronic pain rates changed over time. Event rates and confidence intervals with random effect models and Freeman-Tukey double arcsine variance-stabilizing transformation were obtained separately for the incidence of chronic pain based on 1,439 patients from 17 studies at 3 months and 1,354 patients from 15 studies at 6 months. The incidences of chronic pain at 3 and 6 months after thoracotomy were 57% (95% confidence interval [CI], 51-64%) and 47% (95% CI, 39-56%), respectively. The average severity of pain ratings on a 0 to 100 scale at these times were 30 ± 2 (95% CI, 26-35) and 32 ± 7 (95% CI, 17-46), respectively. Reported chronic pain rates have been largely stable at both 3 and 6 months from the 1990s to the present.

Perspective: This systematic review's findings suggest that reported chronic pain rates are approximately 50% at 3 and 6 months and have been largely stable from the 1990s to the present. The severity of this pain is not consistently reported. Chronic pain after thoracotomy continues to be a significant problem despite advancing perioperative care.

Keywords: Chronic pain; incidence; meta-analysis; thoracic surgery; thoracotomy.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Chronic Pain / epidemiology*
  • Humans
  • Incidence
  • Pain Measurement
  • Pain, Postoperative / epidemiology*
  • Thoracotomy / adverse effects*