Chronic postsurgical pain in patients 5 years after cardiac surgery: A prospective cohort study

Eur J Pain. 2017 Mar;21(3):425-433. doi: 10.1002/ejp.918. Epub 2016 Jul 26.

Abstract

Background: Chronic postsurgical pain (CPSP) is a common complication after many surgical procedures, including cardiac surgery. The prevalence of CPSP after cardiac surgery ranges from 9.5% to 56%. Most studies on CPSP after cardiac surgery are retrospective and long-term prospective studies are scarce. The aim of this study was to follow CPSP and health-related quality of life (HRQOL) prospectively in a cohort of patients, emphasizing the prevalence from 12 months to 5 years.

Methods: A total of 534 patients (23% ≥75 years, 67% men) were consecutively included before surgery. Study-specific questionnaires and the Brief Pain Inventory (BPI) were used to measure CPSP at baseline, 12 months and 5-year follow-up. Short-Form Health Survey (SF-36) was used to measure HRQOL.

Results: Among 458 patients who were alive after 5 years, 82% responded (n = 373). The majority, 89.8% (335/373), did not report CPSP, neither 12 months nor 5 years after surgery. Among the 38 patients who reported CPSP after 12 months, 24 (63%) patients did not report CPSP after 5 years. The overall prevalence of CPSP after 5 years was 3.8% (14/373). Patients reporting CPSP and resolved CPSP had lower scores on HRQOL and more pain preoperatively than patients who did not report CPSP.

Conclusions: The prevalence of CPSP was lower in this study than previously reported. Among the patients reporting CPSP at 12 months, 63% did not report CPSP after 5 years. Hence, the observed decline in CPSP is in line with studies evaluating CPSP in noncardiac surgery.

Significance: The prevalence of chronic postsurgical pain (CPSP) at 5 years after surgery of 3.8% is lower than previously reported. The majority of patients reporting CPSP after 12 months did not report CPSP after 5 years.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiac Surgical Procedures / adverse effects*
  • Chronic Pain / epidemiology
  • Chronic Pain / etiology*
  • Chronic Pain / psychology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / complications*
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / psychology
  • Prevalence
  • Prospective Studies
  • Quality of Life
  • Risk Factors