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:BACKGROUND:Chronic postsurgical pain (CPSP) after hernia repair research has mainly relied on unconfirmed self-reporting. We aimed to describe confirmed CPSP incidence, management, and quality of life (QoL) in a 2-year prospective study. METHODS:Multicenter study (GENDOLCAT) of 3890 patients undergoing 4 common surgical procedures in 23 hospitals to develop a risk model for CPSP; 2352 men underwent open hernia repair. Patients with pain were identified by telephone at 1 and 3?months and referred to the hospital 4?months after surgery for a physical examination to confirm CPSP. Three validated tools were used: the Brief Pain Inventory (BPI) for severity, analgesic use, and interference with activities; the SF-12 questionnaire for QoL (validated Spanish version), and the Douleur Neuropathique 4 (DN4). Patients with CPSP were called again at 1 and 2?years. RESULTS:In 1761 patients who underwent hernia repair and were eligible for physical examination for CPSP, the incidence of confirmed pain at 4?months was 13.6% (patient-reported pain, 6.2% at 1?year and 4.0% at 2?years). Neuropathic pain was diagnosed in 38.5% of the CPSP patients at 4?months. The incidences of neuropathic CPSP in patients with mesh or non-mesh repairs were similar (38.6 and 33.3%, respectively). SF-12 physical component scores changed little in all patients, whether or not they developed CPSP. The SF-12 mental component decreased significantly in all patients, but the decrease was clinically significant only in CPSP patients. CPSP interfered with activities (18%), work (15.6%), walking (15%) and mood (10.2%). At 2?years 52.1% of CPSP patients had moderate/intense pain and 28.2% took analgesics. CONCLUSION:CPSP affects QoL-related activities, and although it diminishes over the course of 2?years after surgery, many patients continue to have moderate/intense pain and take analgesics. CPSP and neuropathic pain rates seem to be similar after mesh and non-mesh repair. BPI and SF-12 mental component scores detect effects on QoL. TRIAL REGISTRATION:ClinicalTrials.gov NCT01510496.

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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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