Classification of Acute Pain Trajectory After Breast Cancer Surgery Identifies Patients at Risk for Persistent Pain: a Prospective Observational Study

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2018 Oct 17

PMID 30323654

Citations 22

Authors

Akiko Okamoto

Masaki Yamasaki

Isao Yokota

Maiko Mori

Megumi Matsuda

Yosuke Yamaguchi

Shunsuke Yamakita

Hiroshi Ueno

Teiji Sawa

Tetsuya Taguchi

Toyoshi Hosokawa

Fumimasa Amaya

Affiliations

Soon will be listed here.

Abstract

Purpose: Predictive value and accuracy of the acute pain trajectory were compared with those of pain intensity at 1 day after the surgery for pain prevalence at 6 months after the surgery.

Materials And Methods: Female patients scheduled for breast cancer surgery were eligible for this study. Patients were questioned about pain intensity daily during the 7 days after surgery. Presence of pain, its location, and intensity as well as the Japanese version of the quality of the recovery-40 (QOR-40) were determined in an interview prior to and at 6 months after the surgery. Acute pain trajectory was determined by a group-based trajectory modeling analysis that was based on the pain intensity at 1-7 days after surgery. Predictive value of the acute pain trajectory for the presence of pain at 6 months after the surgery was assessed by a logistic regression model. The predictive value was compared with pain intensity at 1 day after the surgery.

Results: A total of 123 participants completed the 6-month follow-up. The three-cluster model (mild, moderate, and severe pain) was considered to be the most statistically appropriate model for the acute pain trajectory. After 6 months, 51.2% and 8.9% of participants reported pain and severe pain, respectively. Presence of pain at 6 months after the surgery was associated with poor recovery. The severe pain cluster was significantly associated with the presence of pain at 6 months after the surgery (adjusted odds ratio, 9.40; <0.001 vs mild pain cluster).

Conclusion: Classification of patients according to the acute pain trajectory, when compared with the classification according to pain intensity at 1 day after the surgery, made it possible to predict with better precision those patients who will develop persistent postsurgical pain.

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