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Trajectories in sev...
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Jensen, Elisabeth KjaerRigshosp, Denmark
(författare)
Trajectories in severe persistent pain after groin hernia repair: a retrospective analysis
- Artikel/kapitelEngelska2021
Förlag, utgivningsår, omfång ...
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2020-10-09
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WALTER DE GRUYTER GMBH,2021
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:liu-173414
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-173414URI
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https://doi.org/10.1515/sjpain-2020-0104DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Objectives: Severe persistent post-surgical pain (PPSP) remains a significant healthcare problem. In the third most common surgical procedure in the U.K., groin hernia repair, including 85,000 surgeries, estimated 1,500-3,000 patients will annually develop severe PPSP. While the trajectory of PPSP is generally considered a continuation of the acute post-surgery pain, recent data suggest the condition may develop with a delayed onset. This study evaluated pain-trajectories in a consecutive cohort referred from groin hernia repair-surgeons to a tertiary PPSP-center. Potential explanatory variables based on individual psychometric, sensory, and surgical profiles were analyzed. Methods: Patients completed graphs on pain trajectories and questionnaires on neuropathic pain, pain-related functional assessments, and psychometrics. Surgical records and quantitative sensory testing profiles were obtained. Pain trajectories were normalized, and pre- and post-surgical segments were analyzed by a normalized area-under-the-curve (AUC) technique. Principal component analysis (PCA) was applied to the explanatory variables. Significant PCA-components were further examined using multiple logistic regression models. Results: In 95 patients, the AUC identified groups of post-surgical pain trajectories (p<0.0001): group I (n=48), acute high-intensity pain progressing to PPSP; group II (n=28), delayed onset of PPSP; group III (n=7), repeat-surgery gradually inducing PPSP. Data from groups IV (n=3) and V (n=9) were not included in the statistical analysis due to small sample size and data heterogeneity, respectively. The PCA/logistic analyses indicated that neuropathic pain scores, composite pain scores, and pain-related functional assessments were explanatory variables for groups I and II. Conclusions: Pain trajectories in PPSP after groin hernia repair are heterogeneous but can be classified into meaningful groups. Examination of pain trajectories, mirroring the transition from acute to severe persistent post-surgical pain, has the potential of uncovering clinically relevant pathophysiological mechanisms.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Bäckryd, EmmanuelLinköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum(Swepub:liu)emmba63
(författare)
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Hilden, JorgenUniv Copenhagen, Denmark
(författare)
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Werner, Mads U.Copenhagen Univ Hosp, Denmark
(författare)
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Rigshosp, DenmarkAvdelningen för prevention, rehabilitering och nära vård
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Scandinavian Journal of Pain: WALTER DE GRUYTER GMBH21:1, s. 70-801877-88601877-8879
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