Veal, FC and Bereznicki, LRE and Thompson, AJ and Peterson, GM and Orlikowski, C, Subacute pain as a predictor of long-term pain following orthopedic surgery: an Australian prospective 12 month observational cohort study, Medicine, 94, (36) Article e1498. ISSN 0025-7974 (2015) [Refereed Article]
Copyright 2015 Wolters Kluwer Health, Inc. Licenced under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 http://creativecommons.org/licenses/by-nc-nd/4.0
The aim of this study was to document the level of pain and functionality in the 12 months following orthopedic surgery and identify if high pain levels following discharge were associated with pain persisting at 12 months.
An observational prospective cohort study was undertaken, following 87 patients (mean age 62.4 years [18-92]; 47.1% male) who required orthopedic surgery at the Royal Hobart Hospital, Australia. Following an initial survey, patients were telephoned at 10 days, 6 weeks, 3 months, and 12 months after discharge.
Postdischarge pain levels were high with 97.4% of patients suffering pain at 10 days, 81.2% at 6 weeks and 79.5% at 3 months. Pain affected the ability to undertake activities of daily living (ADLs) for 32.7% and 20.0% of patients at 10 days and 6 weeks, respectively. Twelve months after discharge, 65.5% of patients reported pain persisting at the surgical site, with 29.9% of all patients suffering moderate-severe incidental pain; and nearly one quarter of patients reported pain affected their sleep or ADLs. Average pain levels rated as moderate-severe at 10 days (P = 0.01) and 6 weeks (P = 0.02) and pain of neuropathic origin at 3 months (30.2% vs 10.3% P = 0.03) and 12 months (30.4% vs 4.9% P = 0.01) were associated with persistent pain at 12 months.
Pain in the period following discharge from hospital is significant and undermanaged. Previous studies has shown that that acute pain, particularly in the first 48 hours following surgery is a predictor for long-term pain after surgery. This study adds to the current literature by showing that pain in the subacute period, following discharge from hospital is also associated with the pain persisting at 12 months. These findings have important implications for improving quality of life as well as potentially preventing persistent pain with increased follow-up and more intensive management of post-discharge pain.
|Item Type:||Refereed Article|
|Keywords:||pain, elderly, orthopaedic|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Pharmacology and pharmaceutical sciences|
|Research Field:||Clinical pharmacy and pharmacy practice|
|Objective Group:||Other health|
|Objective Field:||Other health not elsewhere classified|
|UTAS Author:||Veal, FC (Dr Felicity Veal)|
|UTAS Author:||Bereznicki, LRE (Professor Luke Bereznicki)|
|UTAS Author:||Thompson, AJ (Mr Angus Thompson)|
|UTAS Author:||Peterson, GM (Professor Gregory Peterson)|
|UTAS Author:||Orlikowski, C (Dr Chris Orlikowski)|
|Web of Science® Times Cited:||27|
|Downloads:||199 View Download Statistics|
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