Dataset Information

Chronic pain after breast surgery: incidence, associated factors, and impact on quality of life, an observational prospective study.

ABSTRACT:

Background

Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients' function and quality of life is also described.

Methods

Women aged 18+ undergoing oncological or reconstructive breast surgery from Jan until Apr 2018 at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was measured at 0?h, 3?h, 6?h, 12?h, 24?h, 48?h, and 3?months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis.

Results

Among the 307 patients considered in this study, the incidence of CPBS was 28% [95% CI 23.1-33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95% CI], 2.99 [1.13-7.87], p?=?0.03), preoperative use of pain medications (OR [95% CI], 2.04 [1.20-3.46], p?=?0.01), and higher dynamic NRS values at 6?h postoperatively (OR [95% CI], 1.28 [1.05-1.55], p?=?0.01) were all independent predictors for CPBS.

Conclusions

Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for pre-existing chronic pain, axillary surgery, and higher dynamic NRS values at 6?h postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation.

Trial registration

ClinicalTrials.gov registration NCT04309929 .

SUBMITTER: Villa G

PROVIDER: S-EPMC7903732 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Chronic pain after breast surgery: incidence, associated factors, and impact on quality of life, an observational prospective study.

Villa Gianluca G Mandarano Raffaele R Scirè-Calabrisotto Caterina C Rizzelli Valeria V Del Duca Martina M Montin Diego Pomarè DP Paparella Laura L De Gaudio A Raffaele AR Romagnoli Stefano S

Perioperative medicine (London, England) 20210224 1

<h4>Background</h4>Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients' function and q ...[more]

PMID: 33622393

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Project description:Although intraperitoneal surgery is a major operation associated with postoperative acute kidney injury (AKI), the incidence, risk factors, and long-term renal outcome are not well known. We aimed to determine the risk factors and 6 months renal outcome in patients with clinical or subclinical AKI after hepatobiliary surgery. We also assessed the validity of urine neutrophil gelatinase-associated lipocalin (NGAL) in the early detection of AKI or prediction of renal outcome.This prospective observational study enrolled patients with normal renal function who underwent hepatobiliary surgeries. Urine and serum samples were collected for NGAL measurement.Among 131 patients, 10 (7.6%) developed postoperative AKI. Urine NGAL at 12 h postsurgery was the most predictive parameter for the diagnosis of AKI (cutoff, 92.85 ng/mL). With the cutoff value, subclinical AKI was diagnosed in 42 (32.1%) patients. Patients with clinical AKI and those with subclinical AKI were assigned to the AKI group. The AKI group had significantly higher model for end-stage liver disease and sodium (MELD-Na) score, lower albumin level, and longer hospital stay after surgery than the non-AKI group. Older age and higher MELD-Na score were independent risk factors for the development of postoperative AKI. At 6 months postsurgery, the estimated glomerular filtration rate (eGFR) in the AKI group was significantly lower than that in the non-AKI group, although the baseline eGFR was not different. In multiple linear regression analysis, the maximum urine NGAL level during 24 h postsurgery, intraoperative fluid balance, and having liver transplantation were significantly associated with a poor 6 months renal outcome.Urine NGAL was useful in the early diagnosis of postoperative AKI as well as in predicting the 6 months renal outcome after hepatobiliary surgery. A considerable proportion of patients developed subclinical AKI, and these patients showed worse renal outcome compared with the non-AKI group.

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Dataset Information

Chronic pain after breast surgery: incidence, associated factors, and impact on quality of life, an observational prospective study.

Background

Methods

Results

Conclusions

Trial registration

Publications

Chronic pain after breast surgery: incidence, associated factors, and impact on quality of life, an observational prospective study.

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