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Lookup NU author(s): Professor Vera Araujo-SoaresORCiD
This is the authors' accepted manuscript of an article that has been published in its final definitive form by Lippincott Williams & Wilkins, Ltd, 2018.
For re-use rights please refer to the publisher's terms and conditions.
Chronic post-surgical pain (CPSP) is a well-recognized potential complication with negative personal, social and healthcare consequences. However, limited data exists on CPSP and on the course of pain over time after hysterectomy. Using data from a prospective cohort study on a consecutive sample assessed at 4 time points, pre-surgery (T1), 48 hours (T2), 4 months (T3), and 5 years post-surgery (T4), we sought to examine women’s post-surgical pain trajectories using assessments of pain at T3 and T4. Additionally, this study aimed to investigate pre-surgical and post-surgical risk factors associated with an unfavourable pain trajectory (PT). Based on pain data collected at T3 and T4, three distinct trajectories of post-surgical pain (PSP) emerged: no CPSP (PT1;n=88), prolonged PSP (PT2;n=53) and CPSP (PT3;n=29). Moreover, reported CPSP prevalence at 5 years was 17.1%. Multinomial logistic regression models controlling for age, pre-surgical pain and type of hysterectomy tested for baseline and acute post-surgical predictive variables. Membership in PT2 and PT3 was predicted by pre-surgical anxiety (OR=1.131, p=0.015; OR=1.175, p=0.009, respectively), emotional representation of the surgical disease (OR=1.155, p=0.034; OR=1.213, p=0.020, respectively) and pain catastrophizing (OR=1.079, p=0.043; OR=1.143, p=0.001, respectively). Furthermore, acute post-surgical pain intensity and frequency (at T2) determined membership of women in PT3 (OR=1.211, p=0.033; OR=3.000, p=0.029, respectively), and post-surgical anxiety at T2 (OR=1.182, p=0.026) also played a key predictive role. This study identified factors that can be easily screened before and after surgery, and are amenable to change through carefully designed timely and tailored interventions for women at risk of an unfavorable post-surgical pain trajectory post-hysterectomy.
Author(s): Pinto PR, McIntyre T, Araújo-Soares V, Almeida A, Costa P
Publication type: Article
Publication status: Published
Journal: PAIN
Year: 2018
Volume: 159
Issue: 5
Pages: 956-967
Print publication date: 01/05/2018
Online publication date: 05/02/2018
Acceptance date: 03/01/2018
Date deposited: 17/07/2018
ISSN (print): 0304-3959
ISSN (electronic): 1872-6623
Publisher: Lippincott Williams & Wilkins, Ltd
URL: https://doi.org/10.1097/j.pain.0000000000001170
DOI: 10.1097/j.pain.0000000000001170
Notes: This paper is first authored by a former PhD student of mine. We designed and initiated this prospective cohort study in 2008. The original paper has attracted 75 citations (google scholar:Pinto PR*, McIntyre T, Almeida A & Araújo-Soares V (2012). Understanding pre-surgical predictors of acute pain experience following hysterectomy for benign causes: Conceptual and methodological issues. Pain, 153(9), 1974-1976. DOI: 10.1016/j.pain.2012.05.022 (IF 5.557). This paper is the five-year follow-up paper that was just accepted, again by the journal PAIN and was selected by the Journal Editor-in-Chief, Francis J Keefe, as an Editor’s Choice article. This means that the paper will be featured in the journal and on its website.
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