Dataset Information

Characterizations of Temporal Postoperative Pain Signatures With Symbolic Aggregate Approximations.

ABSTRACT: The primary aim was to characterize the temporal dynamics of postoperative pain intensity using symbolic aggregate approximation (SAX). The secondary aim was to explore the effects of sociodemographic and clinical factors on the SAX representations of postoperative pain intensity.We applied SAX to a large-scale time series database of 226,808 acute postoperative pain intensity ratings. Pain scores were stratified by patient age, sex, type of surgery, home opioid use, and postoperative day (POD), and costratified by age and sex. Cosine similarity, a metric that measures distance using vector angle, was applied to these motif data to compare pain behavior similarities across strata.Across age groups, SAX clusters revealed a shift from low-to-low pain score transitions in older patients to high-to-high pain score transitions in younger patients, whereas analyses stratified by sex showed that males had a greater focus of pain score transitions among lower-intensity pain scores compared with females. Surgical stratification, using cardiovascular surgery as a reference, demonstrated that pulmonary surgery had the highest cosine similarity at 0.855. With POD stratification, POD 7 carried the greatest cosine similarity to POD 0 (0.611) after POD 1 (0.765), with POD 3 (0.419) and POD 4 (0.441) carrying the lowest cosine similarities with POD 0.SAX offers a feasible and effective framework for characterizing large-scale postoperative pain within the time domain. Stratification of SAX representations demonstrate unique temporal dynamic profiles on the basis of age group, sex, type of surgery, preoperative opioid use, and across PODs 1 to 7.

SUBMITTER: Tighe PJ

PROVIDER: S-EPMC5097898 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Characterizations of Temporal Postoperative Pain Signatures With Symbolic Aggregate Approximations.

Tighe Patrick J PJ Nickerson Paul P Fillingim Roger B RB Rashidi Parisa P

The Clinical journal of pain 20170101 1

<h4>Objectives</h4>The primary aim was to characterize the temporal dynamics of postoperative pain intensity using symbolic aggregate approximation (SAX). The secondary aim was to explore the effects of sociodemographic and clinical factors on the SAX representations of postoperative pain intensity.<h4>Materials and methods</h4>We applied SAX to a large-scale time series database of 226,808 acute postoperative pain intensity ratings. Pain scores were stratified by patient age, sex, type of surge ...[more]

PMID: 27153359

Similar Datasets

Project description:Shoulder surgery is a primary intervention for shoulder pain, yet many individuals experience persistent postoperative pain. Previously, we found individuals categorized as having a high-risk phenotype (comprised of COMT variation and pain catastrophizing) had approximately double the chance of not reaching a 12-month pain recovery criterion. As a means to better understand the development of persistent postoperative shoulder pain, this study advanced our previous work by examining temporal ordering of postoperative shoulder recovery based on potential mediating factors, and expansion of outcomes to include movement-evoked pain and shoulder active range of motion. Before surgery, individuals were categorized as either high-risk (high pain catastrophizing, COMT-genotype linked to low enzyme activity [n = 41]) or low-risk (low pain catastrophizing, COMT-genotype linked to normal enzyme activity [n = 107]). We then compared potential mediating variables at 3, 6, and 12 months postoperatively 1) endogenous pain modulation defined by a conditioned pain modulation paradigm; and 2) and emotion factors such as anxiety, fear of movement, and depressive symptoms. At 3 months, the high-risk subgroup had higher fear and movement-evoked pain, and causal mediation analysis confirmed the direct effect of risk subgroup on 12-month movement evoked pain. However, baseline to 12-month change in depressive symptoms were found to mediate 53% of the total effect of risk subgroup on 12-month movement-evoked pain. This study introduces potential temporal components and relationships to the development of persistent postoperative shoulder pain, which future studies will confirm and assess for potential therapeutic targets. PERSPECTIVE: This study expands upon postoperative shoulder recovery measures to include movement-evoked pain and depressive symptoms, and provides preliminary indication of temporal ordering to postoperative shoulder recovery for a preidentified high-risk subgroup. Future studies will distinguish temporal components of shoulder surgery that may optimize treatment targets of postoperative recovery.

Project description:BackgroundSelective dorsal rhizotomy (SDR) is a neurosurgical procedure that reduces lower limb spasticity, performed in some children with spastic diplegic cerebral palsy. Effective pain management after SDR is essential for early rehabilitation. This study aimed to describe the anaesthetic and early pain management, pain and adverse events in children following SDR.MethodsThis was a retrospective cohort study. Participants were all children who underwent SDR at a single Australian tertiary hospital between 2010 and 2020. Electronic medical records of all children identified were reviewed. Data collected included demographic and clinical data (pain scores, key clinical outcomes, adverse events and side effects) and medications used during anaesthesia and postoperative recovery.Results22 children (n=8, 36% female) had SDR. The mean (SD) age at surgery was 6 years and 6 months (1 year and 4 months). Common intraoperative medications used were remifentanil (100%), ketamine (95%), paracetamol (91%) and sevoflurane (86%). Postoperatively, all children were prescribed opioid nurse-controlled analgesia (morphine, 36%; fentanyl, 36%; and oxycodone, 18%) and concomitant ketamine infusion. Opioid doses were maximal on the day after surgery. The mean (SD) daily average pain score (Wong-Baker FACES scale) on the day after surgery was 1.4 (0.9), decreasing to 1.0 (0.5) on postoperative day 6 (POD6). Children first attended the physiotherapy gym on median day 7 (POD8, range 7-8). Most children experienced mild side effects or adverse events that were managed conservatively. Common side effects included constipation (n=19), nausea and vomiting (n=18), and pruritus (n=14). No patient required return to theatre, ICU admission or prolonged inpatient stay.ConclusionsMost children achieve good pain management following SDR with opioid and ketamine infusions. Adverse events, while common, are typically mild and managed with medication or therapy. This information can be used as a baseline to improve postoperative care and to support families' understanding of SDR before surgery.

Project description:Treatment options and reliable predictive marker to determine patients at risk to develop postoperative LD and to define the optimal time point of liver resection are limited. Accordingly, there is an urgent need for an easily assessable preoperative test to predict postoperative liver function recovery, specifically as current markers are often expensive, time consuming and sometimes invasive. Emerging evidence suggests that microRNA (miRNA) signatures represent potent diagnostic, prognostic and treatment response biomarkers for several diseases. Using next-generation sequencing as an unbiased systematic approach 554 miRNAs were detected in preoperative plasma of 21 patients suffering from postoperative LD after liver resection and 27 matched controls. Subsequently, we identified a miRNA signature - consisting of miRNAs 151a-5p, 192-5p and 122-5p - that highly correlated with patients developing postoperative LD after liver resection. The predictive potential for postoperative LD was subsequently confirmed using real-time PCR in an independent validation cohort of 98 patients. Ultimately, a regression model of the two miRNA ratios 151a-5p to 192-5p and 122-5p to 151a-5p was found to reliably predict postoperative LD, severe morbidity, prolonged intensive care unit and hospital stay and even mortality prior to surgery with a remarkable accuracy, thereby outperforming established markers of postoperative LD. Ultimately, we documented that miRNA ratios closely followed liver function recovery after partial hepatectomy. Conclusion: Given the clinical relevance of predicting potentially fatal postoperative clinical outcome after liver resection, our data demonstrate the clinical utility of a novel miRNA-based biomarker to support the selection of patients undergoing partial hepatectomy. The dynamical changes during liver function recovery indicate a possible role in tailoring the optimal time point of surgery to each individual patient. Thereby, our data might help to tailor surgical strategies to the specific risk profile of individual patients.

Dataset Information

Characterizations of Temporal Postoperative Pain Signatures With Symbolic Aggregate Approximations.

Publications

Characterizations of Temporal Postoperative Pain Signatures With Symbolic Aggregate Approximations.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets